Individual
KYLE CUSTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
129 KINGS HWY N, WESTPORT, CT 06880-2438
(203) 221-3030
Mailing address
19 TREADWELL LN, WESTON, CT 06883-1949
(203) 223-9167
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
044385
CT
Other
Enumeration date
07/06/2006
Last updated
02/09/2015
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