Provider Demographics
NPI:1003285891
Name:ARNOLD S KIRSHENBAUM MD PA
Entity Type:Organization
Organization Name:ARNOLD S KIRSHENBAUM MD PA
Other - Org Name:ALLERGY HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:SETH
Authorized Official - Last Name:KIRSHENBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-860-1200
Mailing Address - Street 1:12150 ANNAPOLIS RD
Mailing Address - Street 2:SUITE #108
Mailing Address - City:GLENN DALE
Mailing Address - State:MD
Mailing Address - Zip Code:20769-9183
Mailing Address - Country:US
Mailing Address - Phone:301-860-1200
Mailing Address - Fax:301-860-0050
Practice Address - Street 1:12150 ANNAPOLIS RD
Practice Address - Street 2:SUITE #108
Practice Address - City:GLENN DALE
Practice Address - State:MD
Practice Address - Zip Code:20769-9183
Practice Address - Country:US
Practice Address - Phone:301-860-1200
Practice Address - Fax:301-860-0050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-22
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD33409174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1831145903OtherNATIONAL PROVIDER IDENTIFIER