Provider Demographics
NPI:1063489235
Name:KASAMON, KARL M (MD)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:M
Last Name:KASAMON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3001 S HANOVER ST
Mailing Address - Street 2:HARBOR VIEW CANCER CENTER
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21225-1233
Mailing Address - Country:US
Mailing Address - Phone:410-350-3386
Mailing Address - Fax:410-354-0756
Practice Address - Street 1:3001 S HANOVER ST
Practice Address - Street 2:HARBOR VIEW CANCER CENTER
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21225-1233
Practice Address - Country:US
Practice Address - Phone:410-350-3386
Practice Address - Fax:410-354-0756
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0058779207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD210121100Medicaid
MD210121100Medicaid
MDK986Medicare ID - Type Unspecified