Healthcare Provider Details

I. General information

NPI: 1831319888
Provider Name (Legal Business Name): KENDRA HUNT ROSS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KENDRA EILEEN HUNT MD

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 07/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

719 GREEN VALLEY RD SUITE 201
GREENSBORO NC
27408-7014
US

IV. Provider business mailing address

719 GREEN VALLEY RD SUITE 201
GREENSBORO NC
27408-7014
US

V. Phone/Fax

Practice location:
  • Phone: 336-378-1110
  • Fax: 336-378-9986
Mailing address:
  • Phone: 336-378-1110
  • Fax: 336-378-9986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number2007-01243
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: