Provider Demographics
NPI:1497931638
Name:PARRISH, KEVIN MICHAEL (SURGICAL ASSISSTANT)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:MICHAEL
Last Name:PARRISH
Suffix:
Gender:M
Credentials:SURGICAL ASSISSTANT
Other - Prefix:
Other - First Name:KEVIN
Other - Middle Name:MICHAEL
Other - Last Name:PARRISH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SURGICAL ASSISSTANT
Mailing Address - Street 1:12504 GABLE LN
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-5246
Mailing Address - Country:US
Mailing Address - Phone:301-292-6160
Mailing Address - Fax:
Practice Address - Street 1:12504 GABLE LN
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-5246
Practice Address - Country:US
Practice Address - Phone:301-292-6160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-17
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCSA0007246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant