Provider Demographics
NPI:1093929366
Name:O'ROURKE, KIMBERLY KESLER (MD)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:KESLER
Last Name:O'ROURKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:MICHELE
Other - Last Name:KESLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6565 N. CHARLES STREET
Mailing Address - Street 2:SUITE 406
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204-5803
Mailing Address - Country:US
Mailing Address - Phone:443-849-2568
Mailing Address - Fax:410-321-7344
Practice Address - Street 1:6565 N. CHARLES STREET
Practice Address - Street 2:SUITE 406
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-5803
Practice Address - Country:US
Practice Address - Phone:443-849-2568
Practice Address - Fax:410-321-7344
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT186660207V00000X
MDD0068720207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
678MMedicare PIN