MEDICARE: MARK EDWARD KINTER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	9900274	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366434557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK EDWARD KINTER M.D.

Provider Business Mailing Address
First Line	:	6750 CAROLINA BLVD
Second Line	:
City	:	CLYDE
State	:	NC
Zip	:	28721-7052
Country	:	US
Telephone Number	:	828-627-2211
Fax Number	:	828-627-2216

Provider Business Practice Location Address
First Line	:	30 N MAIN ST
Second Line	:
City	:	CANTON
State	:	NC
Zip	:	28716-3805
Country	:	US
Telephone Number	:	828-646-0080
Fax Number	:	828-627-2216

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	10/24/2022

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