Provider Demographics
NPI:1518052240
Name:HARRISON, KEVIN S (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:S
Last Name:HARRISON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3454 ELLICOTT CENTER DR
Mailing Address - Street 2:STE 106
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-4130
Mailing Address - Country:US
Mailing Address - Phone:410-817-9623
Mailing Address - Fax:410-461-0526
Practice Address - Street 1:200 EAST JOPPA ROAD
Practice Address - Street 2:SUITE 204
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286
Practice Address - Country:US
Practice Address - Phone:410-817-9623
Practice Address - Fax:410-461-3760
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2016-03-21
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Provider Licenses
StateLicense IDTaxonomies
MDD00456402084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry