Individual
KEVIN DAVID HIATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2011
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
2019-00268
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/15/2014
Last updated
08/20/2020
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