MR. KENNY IMAN (NPI# 1295801173) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295801173 |
| Entity Type | Individual |
| Full Name | MR. KENNY IMAN |
| Credential | P.A.C. |
| Practice Address |
111 Davis St Salisbury MD 21804-5032 |
| Mailing Address |
4014 Oakland School Rd Salisbury MD 21804-2715 |
| Practice Telephone | 4107494154 |
| Mailing Telephone | 4107261576 |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2009-07-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | C0003072 | MD | Other Service Providers |
| N | 207P00000X | Emergency Medicine | C50000664 | DE | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | CERTIFICATION P.A.C. | 1066952 | 01 |
| DC | DEA REGISTRATION | MI1265405 | 01 |
| MD | P.A. LICENSE | C0003072 | 01 |
| MD | LICENSE CONTROLLED SUBSTA | PA60330 | 01 |
| Street Address |
111 DAVIS ST |
| City | SALISBURY |
| State | MD |
| Zip Code | 21804-5032 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144487760 | Florian Georg Huber | Orthopaedic Surgery | 111 Davis St, Salisbury, MD 21804-5032 | 2008-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578125969 | Lifes Energy Wellness Center Inc. | Community/Behavioral Health | 2324 West Zion Road Suite, Suite 112, Salisbury, MD 21804 | 2019-07-05 |
| 1578125340 | Lifes Energy Wellness Center Inc. | Counselor | 2324 West Zion Road Suite 112, Suite 112, Salisbury, MD 21804 | 2019-07-02 |
| 1093377855 | Lifes Energy Wellness Center Inc. | Clinic/Center | 2324 West Zion Road Suite #112, Salisbury, MD 21804 | 2019-07-02 |
| 1356904874 | Carly Showell Finkbeiner | Behavioral Analyst | 30507 Foxchase Dr, Salisbury, MD 21804 | 2019-04-19 |
| 1750844940 | Clifton Waters | Driver | 206 Davis St, Salisbury, MD 21804 | 2019-04-13 |
| 1487125415 | Rebecca J. Raygor | Social Worker | Wicomico High School, 201 Long Ave., Salisbury, MD 21804 | 2018-12-17 |
| 1639662745 | Peninsula Physical Therapy, LLC | Physical Therapist | 720 E College Ave Ste 11, Salisbury, MD 21804 | 2018-06-13 |
| 1376079533 | Kerry Choplin | Behavior Technician | 8032 Snow Hill Rd., Salisbury, MD 21804 | 2017-05-10 |
| 1558892992 | Three Lower Counties Community Services, Inc. | Clinic/Center | 1647 Woodbrooke Drive, Salisbury, MD 21804 | 2017-03-27 |
| 1508304759 | Driven Physiotherapy, LLC | Clinic/Center | 1029 Zircon Ct., Salisbury, MD 21804 | 2017-02-08 |
| Find all providers in zip 21804 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902399587 | Empire Medical LLC | Specialist | 421 Snow Hill Rd, Salisbury, MD 21804-5629 | 2018-06-08 |
| 1063837474 | Angela Blatus | Specialist | 111 Beach Rd Unit 23, Salisbury, MA 01952-2260 | 2014-02-21 |
| 1720376122 | Jesse Marie Karger | Specialist | 1336 Belmont Ave, Suite 502b, Salisbury, MD 21804-4500 | 2011-07-19 |
| 1225358336 | Ho K. Cho Md Pa | Specialist | 560 Riverside Dr Ste A203, Salisbury, MD 21801-4704 | 2010-06-11 |
| 1073784534 | Jock Simon | Specialist | 30686 Satterfield Ct, Salisbury, MD 21804-2365 | 2008-03-12 |
| 1790836856 | Arcadia Medical P.a. | Specialist | 108 Pine Bluff Rd, Salisbury, MD 21801-7141 | 2007-01-16 |
| 1477600468 | Mid-atlantic Pain Medicine, Pa | Specialist | 322 W Carroll St, Salisbury, MD 21801-5305 | 2007-01-04 |
| 1750477667 | Jethalal S Harkhani | Specialist | 1300 A South Division St, Salisbury, MD 21804 | 2006-10-05 |
| 1336254622 | Stewart Physical Therapy of Rowan County, Inc. | Specialist | 1704 West Innes Street, Salisbury, NC 28144-3611 | 2006-08-20 |
| 1528079704 | William Jeremy Bails | Specialist | 6508 Deer Pointe Drive, Suite D, Salisbury, MD 21804-1669 | 2006-08-11 |
| Find all providers in SALISBURY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.