Fussell, Kevin M

Fussell, Kevin M is an individual health care provider with primary practice located at 326 Santa Fe Dr Ste 100 , Encinitas CA 92024-5157. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Fussell, Kevin M can be contacted via phone (760) 230-8994.

Contact Information

Primary practice address
326 Santa Fe Dr Ste 100 Encinitas CA 92024-5157
Phone: (760) 230-8994
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X C172323 California
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 067298 Georgia
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 0101269338 Virginia
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X C172323 California
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 0101269338 Virginia

Profile Details

NPI number 1164404901
LBN Legal business name Fussell, Kevin M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 17th, 2005
Last updated Aug 11th, 2021 - about 3 years 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164404901 NPPES
Georgia MEDICAID 003121258A
Georgia MEDICAID 003121258D

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