Individual
KENNETH D. OWEN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1900 BRUNSWICK AVE, CHARLOTTE, NC 28207-1822
(704) 302-8400
(704) 358-4451
Mailing address
PO BOX 601643, CHARLOTTE, NC 28260-1643
(704) 335-4400
(704) 358-4400
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
34700
NC
207RC0000X
Cardiovascular Disease Physician
Primary
34700
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922117191
—
NC
05
—
5905027
—
NC
05
—
N34700
—
SC
Enumeration date
08/30/2006
Last updated
09/24/2018
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