Healthcare Provider Details

I. General information

NPI: 1003072000
Provider Name (Legal Business Name): KYLE CHARLES MILLS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2008
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 BILTMORE AVE
ASHEVILLE NC
28801-4601
US

IV. Provider business mailing address

PO BOX 63126
CHARLOTTE NC
28263-3126
US

V. Phone/Fax

Practice location:
  • Phone: 828-213-1111
  • Fax: 706-653-4449
Mailing address:
  • Phone: 800-475-6112
  • Fax: 706-653-4449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License NumberMD.35819
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number2012-00340
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: