MEDICARE: DR. KENYA A. MCNEAL-TRICE 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	208000000X	Pediatrics Physician	2005-00929	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	:	1437176138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENYA A. MCNEAL-TRICE M.D.

Provider Business Mailing Address
First Line	:	UNC SCHOOL OF MEDICINE
Second Line	:	CAMPUS BOX 7593
City	:	CHAPEL HILL
State	:	NC
Zip	:	27599-7593
Country	:	US
Telephone Number	:	919-966-3172
Fax Number	:	919-966-8419

Provider Business Practice Location Address
First Line	:	UNC SCHOOL OF MEDICINE
Second Line	:	CAMPUS BOX 7593
City	:	CHAPEL HILL
State	:	NC
Zip	:	27599-7593
Country	:	US
Telephone Number	:	919-966-3172
Fax Number	:	919-966-8419

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	06/04/2013

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