Individual
KEITH PAUL KITTELBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4420 LAKE BOONE TRL, RALEIGH, NC 27607-7505
(919) 784-3034
Mailing address
PO BOX 18139, RALEIGH, NC 27619-8139
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
9300189
NC
207LP2900X
Pain Medicine (Anesthesiology) Physician
9300189
NC
208VP0014X
Interventional Pain Medicine Physician
9300189
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
132EV
BCBS NC
NC
01
—
25212
PARTNERS
NC
01
—
57299
MEDCOST
NC
01
—
6736408
CIGNA
NC
05
—
89132EV
—
NC
Enumeration date
08/31/2006
Last updated
12/11/2007
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