Provider Demographics
NPI:1437140209
Name:BARRETT, KULLI M (MD)
Entity Type:Individual
Prefix:DR
First Name:KULLI
Middle Name:M
Last Name:BARRETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 BORTHWICK AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-4174
Mailing Address - Country:US
Mailing Address - Phone:603-436-3433
Mailing Address - Fax:603-427-5115
Practice Address - Street 1:330 BORTHWICK AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-4174
Practice Address - Country:US
Practice Address - Phone:603-436-3433
Practice Address - Fax:603-427-5115
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11238207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME249900099Medicaid
NH30201693Medicaid
ME249900099Medicaid
NHBARE6363Medicare ID - Type Unspecified
MEBAMM9477Medicare ID - Type Unspecified