Provider Demographics
NPI:1871903864
Name:MICHAEL H. KANE, M.D., LLC
Entity type:Organization
Organization Name:MICHAEL H. KANE, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:HARVEY
Authorized Official - Last Name:KANE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-821-3674
Mailing Address - Street 1:688 POOLE RD STE A
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-6179
Mailing Address - Country:US
Mailing Address - Phone:443-821-3674
Mailing Address - Fax:443-821-3677
Practice Address - Street 1:688 POOLE RD STE A
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-6179
Practice Address - Country:US
Practice Address - Phone:443-821-3674
Practice Address - Fax:443-821-3677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-30
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA25802ZEA5OtherMEDICARE PTAN
MD225138OtherMEDICARE PTAN