Healthcare Provider Details

I. General information

NPI: 1306894829
Provider Name (Legal Business Name): TIMOTHY KUO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 07/11/2024
Certification Date: 07/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10030 GILEAD RD STE 350
HUNTERSVILLE NC
28078-7545
US

IV. Provider business mailing address

PO BOX 60447
CHARLOTTE NC
28260-0447
US

V. Phone/Fax

Practice location:
  • Phone: 704-799-3946
  • Fax: 704-799-3956
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number200501810
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number2005-01810
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: