Healthcare Provider Details

I. General information

NPI: 1063525509
Provider Name (Legal Business Name): MICHAEL A KUHN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 03/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

512 SAYBROOK RD SUITE 100
MIDDLETOWN CT
06457-4788
US

IV. Provider business mailing address

512 SAYBROOK RD SUITE 100
MIDDLETOWN CT
06457-4788
US

V. Phone/Fax

Practice location:
  • Phone: 860-347-7636
  • Fax: 860-894-1802
Mailing address:
  • Phone: 860-347-7636
  • Fax: 860-894-1802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number54906
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number54906
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: