Kinnebrew, Michael Clark

Kinnebrew, Michael Clark is an individual health care provider with primary practice located at 1122 Medical Center Dr , Wilmington NC 28401-7305. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Pathology, which is considered as his primary health care specialty. Kinnebrew, Michael Clark can be contacted via phone (910) 762-2618.

Contact Information

Primary practice address
1122 Medical Center Dr Wilmington NC 28401-7305
Phone: (910) 762-2618
Fax: (910) 763-5173
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Pathology 1223P0106X 96000154 North Carolina

Profile Details

NPI number 1346238862
LBN Legal business name Kinnebrew, Michael Clark
Credentials M.D., D.D.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2005
Last updated Feb 1st, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346238862 NPPES
North Carolina Other 10272203 VOCATIONAL REHABILITATION
North Carolina MEDICAID 8949309 VOCATIONAL REHABILITATION
North Carolina Other 49309 VOCATIONAL REHABILITATION
North Carolina Other 979443 VOCATIONAL REHABILITATION
North Carolina MEDICAID 8994921 VOCATIONAL REHABILITATION

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