Individual
KEVIN CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1202 MEDICAL CENTER DR, WILMINGTON, NC 28401-7307
(910) 341-3300
(910) 251-8824
Mailing address
1202 MEDICAL CENTER DR, WILMINGTON, NC 28401-7307
(910) 341-3300
(910) 341-3321
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
13188
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110224267
RAILROAD MEDICARE
NC
01
—
1287J
BCBS NC
NC
05
—
891287J
—
NC
Enumeration date
08/11/2006
Last updated
08/05/2014
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