Kenneth Walter Minton, M.D.
Individual provider Active NPI Anatomic Pathology Physician · Jacksonville, MD
NPI 1346432028 · NPPES record last updated Jan 25, 2019
Key facts
- NPI
- 1346432028
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anatomic Pathology Physician 207ZP0101X
- License
- D0028651 (MD)
- Practice address
- 14101 Robcaste Rd
Jacksonville, MD 21131-1471 - Phone
- (013) 455-5736
- Fax
- (443) 689-2175
- NPI assigned
- Aug 15, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0028651 | MD | MD | Anatomic Pathology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology Physician | 207ZP0101X | D0028651 | MD | Yes |
Addresses
Primary practice location
14101 Robcaste Rd
Jacksonville, MD 21131-1471
Mailing address
14101 Robcaste Rd
Jacksonville, MD 21131-1471
Phone (301) 455-5736
Other names
- Dr. Kenneth Walter Minton
Other providers in Jacksonville, MD
All providers in Jacksonville, MD · Anatomic Pathology Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.