Provider Demographics
NPI:1295763795
Name:KENDELL, STEVEN F (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:F
Last Name:KENDELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1671
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21501-1671
Mailing Address - Country:US
Mailing Address - Phone:240-964-8342
Mailing Address - Fax:240-964-8337
Practice Address - Street 1:12502 WILLOWBROOK RD STE 380
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-6592
Practice Address - Country:US
Practice Address - Phone:240-964-8585
Practice Address - Fax:240-964-8586
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0872352084P0800X
TN545922084P0800X
NMMD2022-01162084P0800X
MDD945712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000391333OtherANTHEM
OH2640342Medicaid
TN3714470OtherGROUP MEDICARE
OH000000391333OtherANTHEM
OH2640342Medicaid