Healthcare Provider Details

I. General information

NPI: 1073510525
Provider Name (Legal Business Name): CONTANCE ANN KINCIUS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2005
Last Update Date: 07/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1091 KIRKPATRICK RD
BURLINGTON NC
27215-9714
US

IV. Provider business mailing address

1091 KIRKPATRICK RD
BURLINGTON NC
27215-9714
US

V. Phone/Fax

Practice location:
  • Phone: 336-538-1880
  • Fax: 336-538-1895
Mailing address:
  • Phone: 336-538-1880
  • Fax: 336-538-1895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number26286
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: