Individual
KIRK ALLAN CADDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3024 NEW BERN AVE, RALEIGH, NC 27610-1247
(919) 350-2266
(919) 350-7687
Mailing address
PO BOX 603949, CHARLOTTE, NC 28260-3949
(919) 350-2266
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2022-02505
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952690224
—
NC
Enumeration date
04/07/2011
Last updated
10/21/2024
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