Provider Demographics
NPI:1801913918
Name:WINSTEAD, KEVIN S (PA-C)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:S
Last Name:WINSTEAD
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:811 CROMWELL PARK DR
Mailing Address - Street 2:SUITE 104-105
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-2566
Mailing Address - Country:US
Mailing Address - Phone:410-553-0110
Mailing Address - Fax:410-553-0197
Practice Address - Street 1:811 CROMWELL PARK DR
Practice Address - Street 2:SUITE 104-105
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-2566
Practice Address - Country:US
Practice Address - Phone:410-553-0110
Practice Address - Fax:410-553-0197
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2016-06-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDC002657363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD227110ZE8QMedicare PIN