Provider Demographics
NPI:1831107200
Name:BRIAN S KAHAN DO PA
Entity Type:Organization
Organization Name:BRIAN S KAHAN DO PA
Other - Org Name:CENTER FOR PAIN MEDICINE AND PHYSIATRIC REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:KAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:410-571-9000
Mailing Address - Street 1:2002 MEDICAL PKWY
Mailing Address - Street 2:SUITE 150A
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3046
Mailing Address - Country:US
Mailing Address - Phone:410-571-9000
Mailing Address - Fax:410-571-1670
Practice Address - Street 1:2002 MEDICAL PKWY
Practice Address - Street 2:SUITE 150A
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1538
Practice Address - Country:US
Practice Address - Phone:410-571-9000
Practice Address - Fax:410-571-1670
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRIAN S KAHAN DO PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-03
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH538032081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD152482Medicare PIN
MD219ZMedicare PIN