Kendall, Keith S

Kendall, Keith S is an individual health care provider with primary practice located at 700 Mount Hope Ave Ste 620 , Bangor ME 04401-5671. He recently has 3 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Sports Medicine, Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Podiatrist is his primary health care specialty. Kendall, Keith S can be contacted via phone (207) 947-2220.

Contact Information

Primary practice address
700 Mount Hope Ave Ste 620 Bangor ME 04401-5671
Phone: (207) 947-2220
Fax: (207) 947-4073
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Sports Medicine 213ES0000X POD 1057 Maine
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X POD 1057 Maine
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X POD 1057 Maine
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X POD1057 Maine

Profile Details

NPI number 1164490009
LBN Legal business name Kendall, Keith S
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 8th, 2006
Last updated Apr 26th, 2019 - about 5 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 1164490009 NPPES
Maine MEDICAID 431970899

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