Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 0101269539 | VA |
NPI | 1154680098 |
---|---|
Provider Name | Dr. Kendal M Endicott |
First Address | Baltimore, MD 21297-3174 |
Second Address | Falls Church, VA 22042-1205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2012 |
Last Update Date | 31/10/2021 |