Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 2021-01947 | NC |
Y | 208600000X | Surgeon | 2021-01947 | NC |
NPI | 1013394964 |
---|---|
Provider Name | Dr. Kyle Edward Robinson |
First Address | Winston Salem, NC 27127 |
Second Address | Winston Salem, NC 27157-3403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2015 |
Last Update Date | 06/07/2021 |