Donovan, Kenneth Wayne
Donovan, Kenneth Wayne is an individual health care provider with primary practice located at 365 Montauk Ave Room 4.512, New London CT 06320-4700. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Donovan, Kenneth Wayne can be contacted via phone (860) 442-0711.Contact Information
Primary practice address
365 Montauk Ave Room 4.512
New London CT 06320-4700
Phone: (860) 442-0711
Fax: (860) 444-5114
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD12478 | Rhode Island |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 042916 | Connecticut |
Profile Details
| NPI number | 1669447207 |
|---|---|
| LBN Legal business name | Donovan, Kenneth Wayne |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 17th, 2006 |
| Last updated | May 1st, 2024 - about 6 months 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669447207 | NPPES |
| Connecticut | MEDICAID | 001429168 |
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