Modeste, Kevin Andrew
Modeste, Kevin Andrew is an sole proprietor health care provider with primary practice located at Peacehealth Surgical Specialities 3355 Riverbend Dr., Suite 300, Springfield OR 97477. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgical Critical Care, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Modeste, Kevin Andrew can be contacted via phone (541) 222-8333.Contact Information
Primary practice address
Peacehealth Surgical Specialities 3355 Riverbend Dr., Suite 300
Springfield OR 97477
Phone: (541) 222-8333
Fax: (541) 222-8320
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgical Critical Care | 2086S0102X | MD157808 | Oregon |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | MD157808 | Oregon |
Profile Details
| NPI number | 1942447032 |
|---|---|
| LBN Legal business name | Modeste, Kevin Andrew |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 12th, 2009 |
| Last updated | Mar 6th, 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 | 1942447032 | NPPES |
| Oregon | MEDICAID | 500648430 |
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