Skip Navigation

Provider Information for 1962492363

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. WILLIAM THOMAS KEWESHAN DO

Gender: MALE

Individual NPI: 1962492363

Calendar   Last Updated:  2010-07-14
  Certification Date: 

Details

Name Value
NPI 1962492363
Enumeration Date 2005-10-26
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 12294 INDIAN ROCKS RD
LARGO, FL 33774-3001
United States

Phone: 727-595-2534 | Fax: 727-595-5059
View Map External Link
Primary Practice Address 12294 INDIAN ROCKS RD
LARGO, FL 33774-3001
United States

Phone: 727-595-2534 | Fax: 727-595-5059
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID FL 067399400
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 207Q00000X - Family Medicine FL OS0003970