Individual
DR. KENYON MALA CHAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
901 DENIM DR, ERWIN, NC 28339-2307
(910) 897-5521
(910) 897-2003
Mailing address
901 DENIM DR, ERWIN, NC 28339-2307
(910) 897-5521
(910) 897-2003
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
200801349
NC
207R00000X
Internal Medicine Physician
2008-01349
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5910124
—
NC
Enumeration date
08/26/2008
Last updated
08/03/2021
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