Kisamore, Kenneth

Kisamore, Kenneth is an individual health care provider with primary practice located at 14929 Shady Grove Rd Unit K , Rockville MD 20850-7728. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Kisamore, Kenneth can be contacted via phone (301) 424-1050.

Contact Information

Primary practice address
14929 Shady Grove Rd Unit K Rockville MD 20850-7728
Fax: (301) 424-3184
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 0618001710 Virginia
Eye and Vision Services Providers / Optometrist 152W00000X TA0917 Maryland

Profile Details

NPI number 1154364800
LBN Legal business name Kisamore, Kenneth
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2006
Last updated Dec 10th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers