Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 2011-0500 | NC |
N | 207QS0010X | Family Doctor - Sports Medicine | 2011-0500 | NC |
NPI | 1235387820 |
---|---|
Provider Name | Dr. Adam Joseph Kinninger |
First Address | Marion, NC 28752-4972 |
Second Address | Marion, NC 28752-4972 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2008 |
Last Update Date | 03/03/2021 |