Provider Demographics
NPI:1124320957
Name:KAMRA, RITA K (MD)
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:K
Last Name:KAMRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RITA
Other - Middle Name:K
Other - Last Name:PAQUIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 284
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05302-0284
Mailing Address - Country:US
Mailing Address - Phone:207-602-3571
Mailing Address - Fax:207-602-3573
Practice Address - Street 1:208 GRAHAM ST
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-3853
Practice Address - Country:US
Practice Address - Phone:076-023-5712
Practice Address - Fax:207-602-3573
Is Sole Proprietor?:No
Enumeration Date:2010-11-30
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME014425207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1124320957Medicaid