Stillman, Kenneth

Stillman, Kenneth is an individual health care provider with primary practice located at 112 Main St , Northborough MA 01532-1914. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Stillman, Kenneth can be contacted via phone (508) 351-9250.

Contact Information

Primary practice address
112 Main St Northborough MA 01532-1914
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 42871 Massachusetts

Profile Details

NPI number 1053394726
LBN Legal business name Stillman, Kenneth
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 27th, 2005
Last updated Jun 7th, 2011 - about 14 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 1053394726 NPPES
Massachusetts MEDICAID 2071738

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