Provider Demographics
NPI:1821154816
Name:ORSTEAD, KEVIN MICHAEL (PHD, CSA)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:MICHAEL
Last Name:ORSTEAD
Suffix:
Gender:M
Credentials:PHD, CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1032 HARWICH DR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-9535
Mailing Address - Country:US
Mailing Address - Phone:757-482-4701
Mailing Address - Fax:757-482-4701
Practice Address - Street 1:1032 HARWICH DR
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-9535
Practice Address - Country:US
Practice Address - Phone:757-482-4701
Practice Address - Fax:757-482-4701
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
11588653OtherAETNA
VA119434OtherANTHEM
VA31301OtherOPTIMA
68-80014OtherUNITED HEALTHCARE
8575235OtherCIGNA