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Individual
KENTON LANE DOVER
Active
Individual
KENTON LANE DOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2017-00171
NC
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
64852
CT
207RP1001X
Pulmonary Disease Physician
Primary
2017-00171
NC
207RP1001X
Pulmonary Disease Physician
64852
CT
Other
Enumeration date
05/06/2013
Last updated
12/07/2021
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