Provider Demographics
NPI:1538913637
Name:BERMEA, KEVIN CHRISTIAN (MD)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:CHRISTIAN
Last Name:BERMEA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 W FRANKLIN ST APT 232
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1977
Mailing Address - Country:US
Mailing Address - Phone:443-210-1666
Mailing Address - Fax:
Practice Address - Street 1:7615 KENNEDY HL
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78235-4437
Practice Address - Country:US
Practice Address - Phone:443-210-1666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program