Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 2397 | NC |
NPI | 1235102781 |
---|---|
Provider Name | Dr. Richard Daniel Kildow JR. |
First Address | Cape Carteret, NC 28584-9733 |
Second Address | Camp Lejeune, NC 28547-2538 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2006 |
Last Update Date | 21/05/2009 |