Mark A Kandutsch
Family Doctor - Sports Medicine
322 Main St
Bar Harbor
, Maine 04609-1648
Mark A Kandutsch
Family Doctor - Sports Medicine
322 Main St
Bar Harbor
, Maine 04609-1648
(207) 288-8449
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About
Features
Specialties
- Family Doctor - Sports Medicine
Languages spoken
- English
Location
First Address
- Mark A Kandutsch
- 10 Wayman Ln
- Bar Harbor, ME
- Zip : 04609-1625
- Fax : (207) 288-8449
- Phone : (207) 288-5081
Second Address
- Mark A Kandutsch
- 322 Main St
- Bar Harbor, ME
- Zip : 04609-1648
- Fax : (207) 288-8449
- Phone : (207) 288-5081
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QS0010X | Family Doctor - Sports Medicine | MD10687 | ME |
National Provider Identifier
| NPI | 1194795799 |
|---|---|
| Provider Name | Mark A Kandutsch |
| First Address | Bar Harbor, ME 04609-1625 |
| Second Address | Bar Harbor, ME 04609-1648 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/01/2006 |
| Last Update Date | 23/06/2017 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 101990099 | (05) | ME |
| B86514 | (02) | ME |
| MD10687 | MAINE LICENSE (01) | ME |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.