Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | D0058779 | MD |
NPI | 1063489235 |
---|---|
Provider Name | Dr. Karl M. Kasamon |
First Address | Baltimore, MD 21225-1233 |
Second Address | Baltimore, MD 21225-1233 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2006 |
Last Update Date | 04/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
210121100 | (05) | MD |
H38619 | (02) | MD |