Provider Demographics
NPI:1114188372
Name:KANNO, KILOLE A (DO)
Entity Type:Individual
Prefix:
First Name:KILOLE
Middle Name:A
Last Name:KANNO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20010 CENTURY BLVD SUITE 200
Mailing Address - Street 2:EMERGENCY MEDICINE ASSOCIATES
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874
Mailing Address - Country:US
Mailing Address - Phone:240-686-2300
Mailing Address - Fax:240-686-2330
Practice Address - Street 1:7600 CARROLL AVENUE
Practice Address - Street 2:WASHINGTON ADVENTIST HOSPITAL
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912
Practice Address - Country:US
Practice Address - Phone:301-891-5070
Practice Address - Fax:301-891-5132
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0102202205207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine