Individual
REBECCA SMITH KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1331 N ELM ST, SUITE 200, GREENSBORO, NC 27401-6302
(336) 274-9617
(336) 482-2177
Mailing address
1331 N ELM ST, SUITE 200, GREENSBORO, NC 27401-6302
(336) 274-9617
(336) 482-2177
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
33695
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1082
PARTNERS
NC
01
—
30005071
RAILROAD MEDICARE
NC
01
—
48458
BLUE CROSS BLUE SHIELD
NC
01
—
70510
MEDCOST
NC
05
—
8948458
—
NC
Enumeration date
11/22/2005
Last updated
10/15/2014
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