Individual
JEFF LAWRENCE KANTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
23 SUNNYBROOK RD, RALEIGH, NC 27610-1855
(919) 235-6435
Mailing address
2920 HIGHWOODS BLVD, RALEIGH, NC 27604-0010
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2006026942
MO
2080P0206X
Pediatric Gastroenterology Physician
Primary
2018-01805
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204028302
—
MO
01
—
774420
HEALTHLINK
MO
Enumeration date
12/19/2006
Last updated
03/02/2021
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