EARL KIDWELL JR. (NPI# 1689757254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689757254 |
| Entity Type | Individual |
| Full Name | EARL KIDWELL JR. |
| Credential | MD |
| Practice Address |
3104 Lord Baltimore Dr Suite 200 Baltimore MD 21244-2898 |
| Practice Telephone | 4102651501 |
| Practice Fax Number | 4102651504 |
| Mailing Telephone | 4102651501 |
| Mailing Fax Number | 4102651504 |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2020-01-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | MD13643 | DC | Allopathic & Osteopathic Physicians |
| N | 207W00000X | Ophthalmology | D18526 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 188961300 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2041 Georgia Ave Nw Ste 2000, Washington, DC 200602898 | 2028651257 |
| Street Address |
3104 LORD BALTIMORE DR SUITE 200 |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21244-2898 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801898168 | Muhammad Ali Abbas | Psychiatry & Neurology | 3104 Lord Baltimore Dr, Suite 105, Baltimore, MD 21244-2898 | 2005-06-01 |
| 1568815371 | Colleen Elizabeth Mcquate | Physical Therapist | 3104 Lord Baltimore Dr, Suite 100, Baltimore, MD 21244-2898 | 2016-07-16 |
| 1568580447 | Kathryn Conti | Specialist/Technologist | 3104 Lord Baltimore Dr, Suite 100, Baltimore, MD 21244-2898 | 2007-03-27 |
| 1144354952 | Kenneth J Crivelli | Physical Therapist | 3104 Lord Baltimore Dr, Baltimore, MD 21244-2898 | 2007-03-15 |
| 1639203334 | Ann-marie D Champ | Physical Therapist | 3104 Lord Baltimore Dr, Suite 100, Baltimore, MD 21244-2898 | 2007-03-15 |
| 1790819530 | Diomidis Gregory Pirovolidis | Physical Therapist | 3104 Lord Baltimore Dr, Suite 100, Baltimore, MD 21244-2898 | 2007-03-15 |
| 1821122490 | John C Mahoney | Physical Therapist | 3104 Lord Baltimore Dr, Suite 100, Baltimore, MD 21244-2898 | 2007-03-15 |
| 1952435513 | Laurence R Gallager Jr. | Physical Therapist | 3104 Lord Baltimore Dr, Suite 100, Baltimore, MD 21244-2898 | 2007-03-15 |
| 1710011556 | Janice Lee Bowie | Physical Therapist | 3104 Lord Baltimore Dr, Suite 100, Baltimore, MD 21244-2898 | 2007-03-15 |
| 1750476818 | Kernan Physical Therapy | Occupational Therapist | 3104 Lord Baltimore Dr, Executive Park West Ste 100, Baltimore, MD 21244-2898 | 2006-10-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235748468 | Sinnai Behavioral Health Services Inc | Psychiatric Residential Treatment Facility | 3610 Milford Road, Third Floor, Baltimore, MD 21244 | 2020-07-23 |
| 1023655370 | Flourish Healthcare Solutions, LLC | Home Health Aide | 3517 Langrehr Road, Suite 106a, Windsor Hill, MD 21244 | 2019-12-05 |
| 1265078471 | Chika Cares Pre-diabetes Workshop LLC | Public Health or Welfare | St Gabriel Church, 6950 Dogwood Rd, Windsor Mill, MD 21244 | 2019-11-22 |
| 1306318761 | Elana Rose Dorfman | Social Worker | 7205 Rutherford Road, Windsor Mill, MD 21244 | 2018-12-26 |
| 1235618406 | Stacy Solte Antonio | Physical Therapy Assistant | 7141 Security Blvd., Woodlawn, MD 21244 | 2018-08-08 |
| 1831675446 | Martha Marie Brown | Behavior Technician | 7901 Subet Rd, Windsor Mill, MD 21244 | 2018-07-17 |
| 1003306671 | Bk Faithful Enterprises Consulting, LLC | Dentist | 3120 Lord Baltimore Dr Ste 100, Baltimore, MD 21244 | 2018-05-18 |
| 1235640475 | Kingsley Awah | Home Health Aide | 7932 Dunhill Village Cir, Windsor Mill, Baltimore, MD 21244 | 2017-10-16 |
| 1316465917 | Elizabeth Duggan | Occupational Therapist | 7141 Security Blvd, Md 21244, Baltimore, MD 21244 | 2017-09-03 |
| 1326565052 | Latoya Womack | Registered Nurse | 7102 Burford Ct Apt 301, Windsor Mill, MD 21244 | 2017-08-24 |
| Find all providers in zip 21244 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144786104 | Samir Jabbour | Ophthalmology | 600 North Wolfe Street, Johns Hopkins Hospital Wilmer E, Baltimore, MD 21287 | 2019-02-14 |
| 1609238443 | Kelley Bohm | Ophthalmology | 600 N Wolfe St Fl Cornea, Baltimore, MD 21287-0005 | 2016-03-22 |
| 1639597347 | Heather Mcdonagh Tamez | Ophthalmology | 6115 Falls Rd Ste 300, Baltimore, MD 21209-2219 | 2014-03-31 |
| 1588009765 | Thomas Vincent Johnson IIi | Ophthalmology | Wilmer Eye Institute, Johns Hopkins Hospital, 600 North Wolfe Street, Wilmer B-29, Baltimore, MD 21287-0001 | 2013-05-01 |
| 1033471099 | Brinda Muthusamy | Ophthalmology | The Wilmer Eye Institute Johns, 600 North Wolfe Street, Baltimore, MD 21287-0001 | 2012-06-14 |
| 1225398241 | Katherine Fallano | Ophthalmology | 6565 N Charles St Ste 302, Baltimore, MD 21204-5804 | 2012-05-23 |
| 1275899585 | Rowen Ophthalmology PC | Ophthalmology | 301 St.paul Place, Suite 514, Baltimore, MD 21202 | 2012-04-11 |
| 1831455153 | Tin Yan Alvin Liu | Ophthalmology | 600 N Wolfe St Rm 205, Baltimore, MD 21287-0005 | 2012-04-11 |
| 1760776629 | Katelyn Elizabeth Earls | Ophthalmology | 600 N Wolfe Street Maumenee 327, The Johns Hopkins Hospital, Wilmer Institute, Baltimore, MD 21287-9238 | 2011-06-07 |
| 1174833040 | Vincent M. Notarangelo, Md, Pa | Ophthalmology | 3001 S. Hanover Street, Suite 100, Baltimore, MD 21225 | 2010-10-13 |
| Find all providers in BALTIMORE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.