Provider Demographics
NPI:1427123801
Name:SABLE, KENNETH J (DC)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:J
Last Name:SABLE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3261 OLD WASHINGTON RD
Mailing Address - Street 2:SUITE 2010
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-3223
Mailing Address - Country:US
Mailing Address - Phone:301-645-5390
Mailing Address - Fax:301-645-6215
Practice Address - Street 1:3261 OLD WASHINGTON RD
Practice Address - Street 2:SUITE 2010
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-3223
Practice Address - Country:US
Practice Address - Phone:301-645-5390
Practice Address - Fax:301-645-6215
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01765111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR7260001OtherBCBS OF DC
MDM440OtherBCBS OF MD
MDR7260001OtherBCBS OF DC