Provider Demographics
NPI:1770698227
Name:KOLKAS, EUGENIA (MD)
Entity type:Individual
Prefix:
First Name:EUGENIA
Middle Name:
Last Name:KOLKAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 BAY RD
Mailing Address - Street 2:
Mailing Address - City:LAMOINE
Mailing Address - State:ME
Mailing Address - Zip Code:04605-4731
Mailing Address - Country:US
Mailing Address - Phone:843-425-0052
Mailing Address - Fax:
Practice Address - Street 1:50 UNION ST
Practice Address - Street 2:SUITE 3200
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-1534
Practice Address - Country:US
Practice Address - Phone:207-664-5650
Practice Address - Fax:207-664-5651
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18734207V00000X
MEMD20419207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC187345Medicaid
SC187345Medicaid