Provider Demographics
NPI:1104884089
Name:KALIL, ARTHUR GEORGE JR (DPM)
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:GEORGE
Last Name:KALIL
Suffix:JR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1313
Mailing Address - Street 2:
Mailing Address - City:FORESTDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02644-0715
Mailing Address - Country:US
Mailing Address - Phone:508-833-0011
Mailing Address - Fax:508-833-4778
Practice Address - Street 1:23 WHITES PATH
Practice Address - Street 2:UNIT A2
Practice Address - City:SOUTH YARMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02664-1221
Practice Address - Country:US
Practice Address - Phone:508-833-0011
Practice Address - Fax:508-833-4778
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-02
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1953213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U29443Medicare UPIN
Y70949Medicare ID - Type Unspecified