Provider Demographics
NPI:1346218245
Name:KESSELMAN, AMY J (MD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:J
Last Name:KESSELMAN
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 631001
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21263-1001
Mailing Address - Country:US
Mailing Address - Phone:301-652-5111
Mailing Address - Fax:
Practice Address - Street 1:2440 M ST NW
Practice Address - Street 2:#510
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1404
Practice Address - Country:US
Practice Address - Phone:301-652-5111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD18030207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC613373080Medicare PIN
DCF05672Medicare UPIN
DC613373080Medicare ID - Type Unspecified