Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 38137 | NC |
N | 111NI0900X | Internist | 38137 | NC |
N | 207RA0401X | Internist - Addiction Medicine | 38137 | NC |
Y | 207RR0500X | Rheumatology | 38137 | NC |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 38137 | NC |
NPI | 1598773343 |
---|---|
Provider Name | Kevin M. Mcknight |
First Address | Atlantic Beach, NC 28512-0966 |
Second Address | Pine Knoll Shores, NC 28512-6135 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 01/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1598773343 | (05) | NC |
57265 | BC BS (01) | NC |
E75939 | (02) | |
E75939 | (02) | NC |