Individual
CAELAN RIVER SCOTT KIVETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3140 ROWENA AVE, DURHAM, NC 27703-4447
(860) 918-0020
Mailing address
3140 ROWENA AVE, DURHAM, NC 27703-4447
(860) 918-0020
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
031107-01
NY
363AM0700X
Medical Physician Assistant
Primary
0010-04332
NC
Other
Enumeration date
08/22/2013
Last updated
04/03/2024
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