Provider Demographics
NPI:1912173394
Name:EANES, KEVIN MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:MICHAEL
Last Name:EANES
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 1:53 CAPE HENLOPEN DR
Mailing Address - Street 2:APARTMENT 49
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1170
Mailing Address - Country:US
Mailing Address - Phone:302-562-3541
Mailing Address - Fax:
Practice Address - Street 1:424 SAVANNAH ROAD
Practice Address - Street 2:BEEBE MEDICAL CENTER
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1462
Practice Address - Country:US
Practice Address - Phone:302-645-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2012-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0009441207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine