Individual
DR. KERRY MARK SHAFRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
17039 KENTON DR STE 100, CORNELIUS, NC 28031-5776
(704) 896-8837
(704) 896-8892
Mailing address
17039 KENTON DR STE 100, CORNELIUS, NC 28031-5776
(704) 896-8837
(704) 896-8892
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
39997
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0179T
BLUE CROSS BLUE SHIELD
NC
Enumeration date
08/18/2006
Last updated
10/20/2021
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