Kendall, Keith S
Kendall, Keith S is an individual health care provider with primary practice located at 700 Mount Hope Ave Ste 620 , Bangor ME 04401-5671. He recently has 3 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Sports Medicine, Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Podiatrist is his primary health care specialty. Kendall, Keith S can be contacted via phone (207) 947-2220.Contact Information
Primary practice address
700 Mount Hope Ave Ste 620
Bangor ME 04401-5671
Phone: (207) 947-2220
Fax: (207) 947-4073
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Sports Medicine | 213ES0000X | POD 1057 | Maine |
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | POD 1057 | Maine |
| Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X | POD 1057 | Maine |
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | POD1057 | Maine |
Profile Details
| NPI number | 1164490009 |
|---|---|
| LBN Legal business name | Kendall, Keith S |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 8th, 2006 |
| Last updated | Apr 26th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164490009 | NPPES |
| Maine | MEDICAID | 431970899 |
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