Individual
THOMAS M KINKEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 BRICKHILL AVE, SOUTH PORTLAND, ME 04106-1999
(207) 773-1728
(207) 772-4062
Mailing address
301 US ROUTE 1, BUILDING C, SCARBOROUGH, ME 04074-7609
(207) 396-8600
(207) 396-8632
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD13629
ME
2088P0231X
Pediatric Urology Physician
MD13629
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
275280099
—
ME
05
—
30200189
—
NH
Enumeration date
05/26/2006
Last updated
02/22/2012
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