Individual
FREDERIC ROSS KAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
20021
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
197353000
—
WV
01
—
26187
MEDCOST
NC
01
—
3575
PARTNERS
NC
01
—
47760
BCBS
NC
01
—
5845342
AETNA
—
05
—
6024157
—
VA
05
—
8947760
—
NC
05
—
Q20021
—
SC
Enumeration date
12/09/2005
Last updated
05/12/2008
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