Provider Demographics
NPI:1689674947
Name:DWIGHT, KARA (DO)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:DWIGHT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:MACHIAS
Mailing Address - State:ME
Mailing Address - Zip Code:04654-3325
Mailing Address - Country:US
Mailing Address - Phone:207-255-0400
Mailing Address - Fax:
Practice Address - Street 1:RR 1 BOX 11
Practice Address - Street 2:
Practice Address - City:MACHIAS
Practice Address - State:ME
Practice Address - Zip Code:04654-9758
Practice Address - Country:US
Practice Address - Phone:207-255-3356
Practice Address - Fax:207-255-0289
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1893207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME43202399Medicaid
ME061470OtherANTHEM
ME3815294OtherAETNA
ME3815294OtherAETNA
MEME1457Medicare ID - Type Unspecified
ME061470OtherANTHEM