Provider Demographics
NPI:1144498460
Name:HARVEY, KYLE PETER (MD)
Entity type:Individual
Prefix:DR
First Name:KYLE
Middle Name:PETER
Last Name:HARVEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 HAVERHILL STREET
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-1550
Mailing Address - Country:US
Mailing Address - Phone:978-475-4202
Mailing Address - Fax:978-475-4393
Practice Address - Street 1:140 HAVERHILL STREET
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-1550
Practice Address - Country:US
Practice Address - Phone:978-475-4202
Practice Address - Fax:978-475-4393
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301082405208600000X
MA239487208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301082405OtherMI MEDICAL LICENSE #