Provider Demographics
NPI:1427812247
Name:KISMET KETAMINE AND WELLNESS INFUSIONS LLC
Entity type:Organization
Organization Name:KISMET KETAMINE AND WELLNESS INFUSIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MEAGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STEELE
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:301-835-9194
Mailing Address - Street 1:30 W PATRICK ST STE 320
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-5655
Mailing Address - Country:US
Mailing Address - Phone:301-835-9194
Mailing Address - Fax:
Practice Address - Street 1:30 W PATRICK ST STE 320
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-5655
Practice Address - Country:US
Practice Address - Phone:301-835-9194
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty