Provider Demographics
NPI:1407881121
Name:KAPPELMANN, RICHARD K (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:K
Last Name:KAPPELMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1638
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12201-1638
Mailing Address - Country:US
Mailing Address - Phone:207-777-4111
Mailing Address - Fax:207-783-6660
Practice Address - Street 1:100 CAMPUS AVE STE 104
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-6049
Practice Address - Country:US
Practice Address - Phone:207-777-4100
Practice Address - Fax:207-777-8994
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME012933207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME316730099Medicaid
MEE69135Medicare UPIN
MEMM3174Medicare ID - Type Unspecified