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General NPI Number Information
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NPI Number | 1659411924
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Entity Type | Organization
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Legal Business Name | CAROLINA NEPHROLOGY PA
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 02/06/2008
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Provider Practice Location Address
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Address Line | 1704A WAYNE MEMORIAL DRIVE
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City | GOLDSBORO
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State | NC
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Zip | 27534
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Country | US
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Telephone | 919-580-1026
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Fax | 919-580-1027
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Provider Business Mailing Address
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Address Line | 1704A WAYNE MEMORIAL DRIVE
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City | GOLDSBORO
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State | NC
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Zip | 27534
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Country | US
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Telephone | 919-580-1026
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Fax | 919-580-1027
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | ROBERT DAVID KEMP
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Credential | MD
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Telephone | 919-580-1026
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 2005-00739
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 0094-00540
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License Number State | NC
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