Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 9700211 | NC |
NPI | 1003845363 |
---|---|
Provider Name | Dr. Kenneth M Carnes |
First Address | Raleigh, NC 27607-6000 |
Second Address | Raleigh, NC 27607-6000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2006 |
Last Update Date | 01/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8910522 | (05) | NC |
G30570 | (02) | NC |