Organization
KAIROS MEDICAL CONSULTING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES DUNHAM MD (CO-OWNER)
(336) 909-5939
Entity
Organization
Contact information
Practice address
3000 BETHESDA PL STE 104, WINSTON SALEM, NC 27103-3323
(336) 293-4107
(949) 577-4324
Mailing address
3000 BETHESDA PL STE 104, WINSTON SALEM, NC 27103-3323
(336) 293-4107
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
256596
NC MEDICAL BOARD PROFESSIONAL CORPORATION CERTIFICATE
NC
Enumeration date
12/26/2019
Last updated
09/07/2021
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