Provider Demographics
NPI:1043709314
Name:DURAN, KEVIN BUMATAY (MD)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:BUMATAY
Last Name:DURAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:CHEHALIS FAMILY MEDICINE
Mailing Address - Street 2:931 S. MARKET BLVD
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532
Mailing Address - Country:US
Mailing Address - Phone:360-767-6300
Mailing Address - Fax:360-767-6320
Practice Address - Street 1:931 S. MARKET BLVD
Practice Address - Street 2:
Practice Address - City:CHEHALIS
Practice Address - State:WA
Practice Address - Zip Code:98532
Practice Address - Country:US
Practice Address - Phone:360-767-6300
Practice Address - Fax:360-767-6320
Is Sole Proprietor?:No
Enumeration Date:2018-05-02
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAML60863359207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine