Individual
DR. JOHN KUNNUTHARA JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
744 AIRPORT RD, KINSTON, NC 28504-8800
(252) 523-0026
(252) 523-1855
Mailing address
744 AIRPORT RD, KINSTON, NC 28504-8800
(252) 523-0026
(252) 523-1855
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
200001496
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033105739
INDIVIDUAL NPI
NC
01
—
1273P
BCBS
NC
01
—
1467405431
GROUP NPI
NC
01
—
5908296
EASTERN CAROLINA PHYSICIANS MEDICAID GROUP NUMBER FOR BEULAVILLE
NC
01
—
8901960
EASTERN CAROLINA PHYSICIANS GROUP MEDICAID NUMBER FOR KINSTON
NC
05
—
891273P
—
NC
Enumeration date
09/27/2005
Last updated
10/09/2014
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