Individual
KEVIN KILLEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
8935
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0109136Y0NH01
BLUE CROSS/BLUE SHIELD
NH
01
—
24P100
MVP
NH
01
—
28550
BLUE CROSS/BLUE SHIELD
VT
05
—
30008498
—
NH
01
—
AA37880
HAVARD PILGRIM HEALTHCARE
NH
05
—
ORE2655
—
VT
Enumeration date
03/03/2006
Last updated
08/23/2010
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