Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 2012-02077 | NC |
N | 207PE0004X | Emergency Medical Services | 2012-02077 | NC |
NPI | 1063708287 |
---|---|
Provider Name | Dr. Bryan Benjamin Kitch |
First Address | Charlotte, NC 28275-1069 |
Second Address | Greenville, NC 27834-2818 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2011 |
Last Update Date | 01/12/2020 |