Provider Demographics
NPI:1982047544
Name:DR GARO KEBEJIAN LLC
Entity Type:Organization
Organization Name:DR GARO KEBEJIAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GARO
Authorized Official - Middle Name:
Authorized Official - Last Name:KEBEJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-296-5265
Mailing Address - Street 1:7600 OSLER DR
Mailing Address - Street 2:SUITE 409
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7735
Mailing Address - Country:US
Mailing Address - Phone:410-296-5265
Mailing Address - Fax:410-823-8923
Practice Address - Street 1:7600 OSLER DR
Practice Address - Street 2:SUITE 409
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7735
Practice Address - Country:US
Practice Address - Phone:410-296-5265
Practice Address - Fax:410-823-8923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-14
Last Update Date:2013-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0020181261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4807Medicare UPIN