Provider Demographics
NPI:1417984121
Name:CURTIS, KEVIN J (PA)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:J
Last Name:CURTIS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:96 CAMPUS DR
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-7133
Mailing Address - Country:US
Mailing Address - Phone:207-885-8777
Mailing Address - Fax:208-885-8770
Practice Address - Street 1:96 CAMPUS DR
Practice Address - Street 2:SUITE 2A
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-7133
Practice Address - Country:US
Practice Address - Phone:207-885-8777
Practice Address - Fax:208-885-8770
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MEPA200363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEP41859Medicare UPIN
MEAP 1549Medicare ID - Type Unspecified