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Individual

FRED T KERNS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3100 MACCORKLE AVE SE STE 604, CHARLESTON, WV 25304-1231
(304) 345-5421
(304) 345-0951
Mailing address
3100 MACCORKLE AVE SE STE 604, CHARLESTON, WV 25304-1231
(304) 345-5421
(304) 345-0951

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
11578
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0082907000
WV
Enumeration date
10/11/2006
Last updated
01/18/2008
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