Provider Demographics
NPI:1992741789
Name:SCHENDEL, KEVIN GORDON (MD)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:GORDON
Last Name:SCHENDEL
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9114 PHILADELPHIA RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-4317
Mailing Address - Country:US
Mailing Address - Phone:410-918-0020
Mailing Address - Fax:410-918-0024
Practice Address - Street 1:9114 PHILADELPHIA RD
Practice Address - Street 2:SUITE 300
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-4317
Practice Address - Country:US
Practice Address - Phone:410-918-0020
Practice Address - Fax:410-918-0024
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0039758207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDBS2640452OtherDEA
MD123PMedicare ID - Type Unspecified
MDBS2640452OtherDEA