Provider Demographics
NPI:1306048202
Name:ADKINS, KIMBERLEE J (MD)
Entity type:Individual
Prefix:
First Name:KIMBERLEE
Middle Name:J
Last Name:ADKINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7580 BUCKINGHAM BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-3210
Mailing Address - Country:US
Mailing Address - Phone:410-729-5100
Mailing Address - Fax:
Practice Address - Street 1:5900 WATERLOO RD STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2641
Practice Address - Country:US
Practice Address - Phone:410-740-2900
Practice Address - Fax:410-992-0732
Is Sole Proprietor?:No
Enumeration Date:2007-06-03
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD70888207R00000X
MDD708888208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD512014400Medicaid
MD512014400Medicaid
MD185546Y1PMedicare PIN
185546Y5ZMedicare PIN
MD512014400Medicaid