Provider Demographics
NPI:1215194840
Name:BRIAN S KAHAN DO PA
Entity Type:Organization
Organization Name:BRIAN S KAHAN DO PA
Other - Org Name:THE KAHAN CENTER FOR PAIN MANAGEMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:BILLINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-837-1680
Mailing Address - Street 1:170 JENNIFER RD STE 240
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7995
Mailing Address - Country:US
Mailing Address - Phone:410-571-9000
Mailing Address - Fax:410-266-1507
Practice Address - Street 1:170 JENNIFER RD STE 240
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7995
Practice Address - Country:US
Practice Address - Phone:410-571-9000
Practice Address - Fax:410-266-1507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-21
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH00538032081P2900X
MDD00635442081P2900X
MDD00567132081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD320MMedicare PIN