Individual
DR. TRACY WOGAN KENDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6602 KNIGHTDALE BLVD, SUITE 202, KNIGHTDALE, NC 27545-6525
(919) 747-5270
Mailing address
1600 PERIMETER PARK DR, SUITE 225, MORRISVILLE, NC 27560-8421
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
201376
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2009-00224
MEDICAL LICENSE
NC
05
—
5912522
—
NC
Enumeration date
05/23/2007
Last updated
07/09/2013
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