Healthcare Provider Details

I. General information

NPI: 1124703020
Provider Name (Legal Business Name): KEVIN HOWARD DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2023
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 GRAY RD
FALMOUTH ME
04105-2010
US

IV. Provider business mailing address

75 GRAY RD
FALMOUTH ME
04105-2010
US

V. Phone/Fax

Practice location:
  • Phone: 207-535-1340
  • Fax:
Mailing address:
  • Phone: 207-535-1340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO4406
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: