Provider Demographics
NPI:1811242415
Name:KIME, MICHAEL HUNTER (DPT)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:HUNTER
Last Name:KIME
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14435 CHERRY LANE CT
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4959
Mailing Address - Country:US
Mailing Address - Phone:301-776-3665
Mailing Address - Fax:301-776-6669
Practice Address - Street 1:14435 CHERRY LANE CT
Practice Address - Street 2:SUITE 100
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-4959
Practice Address - Country:US
Practice Address - Phone:301-776-3665
Practice Address - Fax:301-776-6669
Is Sole Proprietor?:No
Enumeration Date:2012-07-19
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24111225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist