Kevin Bettencourt PA-C

NPI 1730496977 - Physician Assistant - 363A00000X

NPI Details
NPI 1730496977
Gender Male
Enumeration Date 09/09/2010
Last Updated 05/18/2015
Entity Type Individual
Active Over 6 years ago
Practice Location
593 EDDY ST
CLAVERICK 2
PROVIDENCE RI, 02903-4923, US
Phone (401) 854-2504
Fax (401) 427-7795
Business Location
125 WHIPPLE ST
3RD FLOOR
PROVIDENCE RI, 02908-3258, US
Phone (401) 854-2504
Fax (401) 427-7795
Toxanomy
Taxonomy Code 363A00000X
License State Florida
License Number PAT9105615
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According to our database, Kevin Bettencourt PA-C NPI is 1730496977, taxonomy code is 363A00000X and license number is PAT9105615, license state is located at Florida. Kevin Bettencourt PA-C physically located at 593 Eddy St, Providence RI, 02903-4923. NPI Number Kevin Bettencourt PA-C has the Individual type.

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1730496977 NPI number is provided on an as is basis without warranty of any kind. 1730496977 is maintained by the National Plan & Provider Enumeration System. The contents of Kevin Bettencourt PA-C are for informational purposes only.