Provider Demographics
NPI:1669546156
Name:KESNER, HOWARD G (DPM)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:G
Last Name:KESNER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1312 PINE RIDGE LANE
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208
Mailing Address - Country:US
Mailing Address - Phone:410-484-4159
Mailing Address - Fax:410-669-4800
Practice Address - Street 1:1133 PENNA AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201
Practice Address - Country:US
Practice Address - Phone:410-669-4800
Practice Address - Fax:410-669-4800
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00377213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD600798800Medicaid
T075Medicare ID - Type Unspecified
MD600798800Medicaid