Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | NC200300630 | NC |
NPI | 1023094026 |
---|---|
Provider Name | Dr. John D Kilde |
First Address | Albemarle, NC 28001-6388 |
Second Address | Albemarle, NC 28001-6387 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2005 |
Last Update Date | 30/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
134PG | BCBSNC (01) | NC |
89134PG | (05) | NC |
9328154 | CIGNA (01) | NC |
H85215 | (02) | |
P01370658 | MEDICARE RAILROAD (01) | NC |
Q0063Y | MEDICAID-SC (01) | SC |