Provider Demographics
NPI:1548349921
Name:KINDER, AMY D (PT)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:D
Last Name:KINDER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 TIDEWATER COLONY DRIVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-2592
Mailing Address - Country:US
Mailing Address - Phone:410-266-8010
Mailing Address - Fax:443-782-2498
Practice Address - Street 1:2001 TIDEWATER COLONY DRIVE
Practice Address - Street 2:SUITE 102
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-2592
Practice Address - Country:US
Practice Address - Phone:410-266-8010
Practice Address - Fax:443-782-2498
Is Sole Proprietor?:No
Enumeration Date:2006-11-04
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16064225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD63737102OtherMARYLAND CAREFIRST BLUE
MD7488417OtherAETNA HEALTHCARE
MDS4410004OtherCAREFIRST BLUE CHOICE
MD285140OtherMAMSI HEALTH CARE
MDS4410004OtherCAREFIRST BLUE CHOICE
MDP72921Medicare UPIN
MD285140OtherMAMSI HEALTH CARE