Individual
KYLE TODD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3175
(207) 662-0111
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3175
(207) 662-0111
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
349800
LA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
349800
LICENSE
LA
Enumeration date
03/22/2021
Last updated
04/15/2026
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