Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 018739 | ME |
N | 208600000X | Surgeon | 018739 | ME |
N | 2082S0105X | Plastic Hand Surgeon | 018739 | ME |
N | 208200000X | Surgeon | 018793 | ME |
N | 208600000X | Surgeon | 018793 | ME |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 018739 | ME |
NPI | 1891807335 |
---|---|
Provider Name | Dr. Richard Henry Kutz III |
First Address | Portland, ME 04106-2430 |
Second Address | Portland, ME 04106-2430 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 02/01/2013 |