Basic Information
| Provider Information | |||||||||
| NPI: | 1851367411 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KARPOWICZ | ||||||||
| FirstName: | KEVIN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3100 WYMAN PARK DR | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212112803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103383500 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1132 ANNAPOLIS RD | ||||||||
| Address2: | |||||||||
| City: | ODENTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211131647 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4108741600 | ||||||||
| FaxNumber: | 4103672202 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/24/2006 | ||||||||
| LastUpdateDate: | 12/17/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 141212-1 | NY | N | Allopathic & Osteopathic Physicians | Family Medicine | 208000000X | D0063929 | MD | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 00488633 | 05 | NY | MEDICAID |