Kristl, Kevin R
Kristl, Kevin R is an sole proprietor health care provider with primary practice located at 1710 E Day Rd , Mishawaka IN 46545-4300. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Kristl, Kevin R can be contacted via phone (574) 252-7795.Contact Information
Primary practice address
1710 E Day Rd
Mishawaka IN 46545-4300
Phone: (574) 252-7795
Fax: (574) 252-7796
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 01037448 | Indiana |
Profile Details
| NPI number | 1811941768 |
|---|---|
| LBN Legal business name | Kristl, Kevin R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 22nd, 2006 |
| Last updated | May 1st, 2018 - about 8 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 | 1811941768 | NPPES |
| Indiana | MEDICAID | 1336414499 | |
| Indiana | MEDICAID | 100179640 |
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