| Neurological Medicine, P.a. | |
|
180 Admiral Cochrane Dr Suite 260 Annapolis MD 21401-7300 | |
| (301) 982-7944 | |
| (301) 441-8696 |
| Full Name | Neurological Medicine, P.a. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 180 Admiral Cochrane Dr, Annapolis, Maryland |
| Authorized Official Name and Position | William R Leahy (PRESIDENT) |
| Authorized Official Contact | 3019827944 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurological Medicine, P.a. 7500 Hanover Pkwy Suite 201 Greenbelt MD 20770-2010 Ph: (301) 982-7944 | Neurological Medicine, P.a. 180 Admiral Cochrane Dr Suite 260 Annapolis MD 21401-7300 Ph: (301) 982-7944 |
| NPI Number | 1497988836 |
|---|---|
| Provider Enumeration Date | 09/02/2009 |
| Last Update Date | 06/21/2010 |
| Medicare PECOS PAC ID | 2860438041 |
|---|---|
| Medicare Enrollment ID | O20100421000451 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497988836 | NPI | - | NPPES |
| 912931600 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Kenneth M Kudelko |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1295725349 PECOS PAC ID: 9335213560 Enrollment ID: I20100421000498 |
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