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NPI Code Detail

MEDICARE: KENNEBEC INTERNAL MEDICINE ASSOCIATES, P.A.

MEDICARE: KENNEBEC INTERNAL MEDICINE ASSOCIATES, P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1811108699
Entity Type Code : Organization
Provider Name (Legal Business Name) : KENNEBEC INTERNAL MEDICINE ASSOCIATES, P.A.
Provider Business Mailing Address
First Line : 9 GLENRIDGE DR
Second Line :
City : AUGUSTA
State : ME
Zip : 04330-6605
Country : US
Telephone Number : 207-623-8434
Fax Number :
Provider Business Practice Location Address
First Line : 9 GLENRIDGE DR
Second Line :
City : AUGUSTA
State : ME
Zip : 04330-6605
Country : US
Telephone Number : 207-623-8434
Fax Number :
Authorized Official
Title or Position : M.D.
Name : KEVIN KANE
Credential :
Telephone Number : 207-623-8434
Provider Enumeration Date : 05/24/2007
Last Update Date : 08/22/2020

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Directions to “KENNEBEC INTERNAL MEDICINE ASSOCIATES, P.A. ” Practice Location

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