Basic Information
Provider Information
NPI: 1912240987
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOLLANDER
FirstName: KIMBERLY
MiddleName: NADEN
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5 CHARING CT
Address2:  
City: OWINGS MILLS
State: MD
PostalCode: 211171296
CountryCode: US
TelephoneNumber: 4105981999
FaxNumber:  
Practice Location
Address1: 22 S GREENE ST FL 11
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212011544
CountryCode: US
TelephoneNumber: 6672141616
FaxNumber: 4103281674
Other Information
ProviderEnumerationDate: 03/28/2013
LastUpdateDate: 10/02/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XD84656MDY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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