Organization
KERNERSVILLE EMERGENCY GROUP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM H LARSEN (DIRECTOR OF CREDENTIALING)
(770) 874-5400
Entity
Organization
Contact information
Practice address
1750 KERNERSVILLE MEDICAL PKWY, KERNERSVILLE, NC 27284-7146
(336) 564-4000
Mailing address
PO BOX 14529, BELFAST, ME 04915-4038
(770) 874-5400
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
12/11/2018
Last updated
02/05/2020
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