Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 26286 | NC |
NPI | 1073510525 |
---|---|
Provider Name | Dr. Contance Ann Kincius |
First Address | Burlington, NC 27215-9714 |
Second Address | Burlington, NC 27215-9714 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2005 |
Last Update Date | 26/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C81455 | (02) | NC |