Provider Demographics
NPI:1821037441
Name:RICHARDS, KEVIN D (DC)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:D
Last Name:RICHARDS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 HEALTH DR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-0240
Mailing Address - Country:US
Mailing Address - Phone:207-623-0720
Mailing Address - Fax:207-623-0724
Practice Address - Street 1:3 HEALTH DR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-0240
Practice Address - Country:US
Practice Address - Phone:207-623-0720
Practice Address - Fax:207-623-0724
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR1582111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME5250494OtherCIGNA
MEAA54001OtherHARVARD PILGRIM
ME010529023OtherCBA/EBPA
ME010529023OtherMEDNET
ME061696OtherANTHEM
ME432079399Medicaid
ME432079399Medicaid
ME010529023OtherMEDNET