Provider Demographics
NPI:1275501959
Name:KAO, GRACE F (MD)
Entity Type:Individual
Prefix:DR
First Name:GRACE
Middle Name:F
Last Name:KAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 64445
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4445
Mailing Address - Country:US
Mailing Address - Phone:410-328-5766
Mailing Address - Fax:410-328-0098
Practice Address - Street 1:405 W REDWOOD ST.
Practice Address - Street 2:6TH FLOOR
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-7005
Practice Address - Country:US
Practice Address - Phone:410-328-5766
Practice Address - Fax:410-328-0098
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD3852207ND0900X
MDD0017574207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD070008599OtherRAILROAD MEDICARE
MD449701500Medicaid
DC028850900Medicaid
DC028850900Medicaid
000X01M83Medicare PIN
D77590Medicare UPIN