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Individual

DR. KENNETH G MACDONALD JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1850 W ARLINGTON BLVD, GREENVILLE, NC 27834-5704
(252) 413-6735
(252) 752-2019
Mailing address
1850 W ARLINGTON BLVD, GREENVILLE, NC 27834-5704
(252) 413-6735
(252) 752-2019

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
27238
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
20033818
RAILROAD MEDICARE
NC
01
53661
BCBS NC
NC
05
8953661
NC
Enumeration date
08/24/2005
Last updated
10/09/2014
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