Provider Demographics
NPI:1902002181
Name:CAIN, KEVIN P (MD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:P
Last Name:CAIN
Suffix:
Gender:M
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:UNIT 8900
Mailing Address - Street 2:BOX 360
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09831-0360
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1600 CLIFTON RD.
Practice Address - Street 2:MS-E-10
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30333
Practice Address - Country:US
Practice Address - Phone:404-639-8120
Practice Address - Fax:404-639-1566
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301077742207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine