Individual
MATTHEW JOHN MCKENNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3102 N CROATAN HWY, KILL DEVIL HILLS, NC 27948-9200
(252) 261-9940
(252) 261-9087
Mailing address
3102 N CROATAN HWY, KILL DEVIL HILLS, NC 27948-9200
(252) 261-9940
(252) 261-9087
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
200500680
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1397C
BCBS
NC
05
—
5902017
—
NC
01
—
P00276854
RR MEDICARE
—
Enumeration date
07/07/2006
Last updated
07/19/2012
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