Individual
DR. KESI TABIA KINDLE-SUERSIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2668 PETERS CREEK PKWY, WINSTON SALEM, NC 27127-5655
(336) 200-7020
Mailing address
PO BOX 746724, ATLANTA, GA 30374-6724
(312) 733-9730
(312) 733-9730
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
200200933
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10100496
—
VA
01
—
13153
BCBS
NC
05
—
3810000708
—
WV
01
—
7706384
AETNA
—
01
—
804752
PARTNERS
—
05
—
8913153
—
NC
01
—
D6480
MEDCOST
—
01
—
H64259
UHC
NC
05
—
Q00933
—
SC
Enumeration date
03/01/2006
Last updated
07/21/2023
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