Individual
MARY BETH KANSORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
200000480
NC
207W00000X
Ophthalmology Physician
Primary
ME131063
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
093AG
BC/BS PROVIDER NUMBER
NC
05
—
89093AG
—
NC
Enumeration date
06/09/2005
Last updated
03/17/2018
Update your record
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