Provider Demographics
NPI:1407964893
Name:FICHT, KAY A (MD)
Entity Type:Individual
Prefix:DR
First Name:KAY
Middle Name:A
Last Name:FICHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 WILLIAM HALL DR
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-6223
Mailing Address - Country:US
Mailing Address - Phone:978-499-8619
Mailing Address - Fax:
Practice Address - Street 1:1 WALLACE BASHAW WAY
Practice Address - Street 2:SUITE 2002
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-3875
Practice Address - Country:US
Practice Address - Phone:978-465-0635
Practice Address - Fax:978-465-0941
Is Sole Proprietor?:No
Enumeration Date:2006-08-27
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA156515207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9770585Medicaid
MAG67675Medicare UPIN
MA9770585Medicaid