Individual
MICHAEL KITSON KACZMAREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1028 LEE ANN DR NE, SUITE 200, CONCORD, NC 28025-2911
(704) 782-1892
Mailing address
1028 LEE ANN DR NE, SUITE 200, CONCORD, NC 28025-2911
(704) 782-1892
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
200501956
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
141V9
BCBS
NC
05
—
225474
—
SC
05
—
5903304
—
NC
Enumeration date
05/04/2006
Last updated
11/21/2013
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