Provider Demographics
NPI:1790845550
Name:KEBEJIAN, GARO (MD)
Entity Type:Individual
Prefix:
First Name:GARO
Middle Name:
Last Name:KEBEJIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7600 OSLER DRIVE
Mailing Address - Street 2:SUITE 409
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204
Mailing Address - Country:US
Mailing Address - Phone:410-296-5265
Mailing Address - Fax:410-823-8923
Practice Address - Street 1:7600 OSLER DRIVE
Practice Address - Street 2:SUITE 409
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204
Practice Address - Country:US
Practice Address - Phone:410-296-5265
Practice Address - Fax:410-823-8923
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0020181207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B70025Medicare UPIN
4807Medicare ID - Type Unspecified