Provider Demographics
NPI:1184725616
Name:SINGLETON, KENNETH BERNARD (MD)
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:BERNARD
Last Name:SINGLETON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8501 LASALLE RD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-5914
Mailing Address - Country:US
Mailing Address - Phone:410-296-3737
Mailing Address - Fax:410-296-0650
Practice Address - Street 1:8501 LASALLE RD
Practice Address - Street 2:SUITE 310
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-5914
Practice Address - Country:US
Practice Address - Phone:410-296-3737
Practice Address - Fax:410-296-0650
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0036621207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD830L057EMedicare ID - Type UnspecifiedINDIVIDUAL
MDA80169Medicare UPIN
MD830LMedicare ID - Type UnspecifiedGROUP NUMBER