Provider Demographics
NPI:1962878017
Name:KEMP, DANIEL ZACHARY (MAC, LACU)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:ZACHARY
Last Name:KEMP
Suffix:
Gender:M
Credentials:MAC, LACU
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 W 39TH ST
Mailing Address - Street 2:APT E2
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210
Mailing Address - Country:US
Mailing Address - Phone:814-241-1134
Mailing Address - Fax:
Practice Address - Street 1:720 W 36TH ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211
Practice Address - Country:US
Practice Address - Phone:814-241-1134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-12
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01868171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist