NPI 1023018074

Kannan Manickam, MD

Practitioner Urology Physician Baltimore, MD

Practice location

Address: 6820 Hospital Dr Suite 210, Baltimore, MD 21237-4352
Phone: (410) 391-6131
Fax: (410) 391-6144
Mailing address: 10200 Grand Central Ave STE 220, Owings Mills, MD 21117-4366

Registered specialties

Urology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208800000X Licence 01056563A (IN)

Other Urology providers in Maryland →

Registry record

NPI: 1023018074
Entity type: Individual
Sex (as registered): Male
NPI issued: 29 Jul 2005
Record last updated: 30 May 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.