Individual
KEVIN DUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
620 SUMMIT CROSSING PL, STE 106, GASTONIA, NC 28054-2176
(704) 867-8021
(804) 864-4606
Mailing address
620 SUMMIT CROSSING PL, STE 106, GASTONIA, NC 28054-2176
(704) 867-8021
(804) 864-4606
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
200200347
NC
2085R0202X
Diagnostic Radiology Physician
Primary
200200347
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
133XA
BLUE CROSS BLUE SHIELD
—
01
—
16 01363
UNITED HEALTHCARE
—
01
—
2829724
AETNA HMO
—
01
—
300135816
RAILROAD MEDICARE
—
01
—
5534697
AETNA PPO
—
01
—
802658
PARTNERS
—
05
—
89133XA
—
NC
01
—
B7685
MEDCOST
—
05
—
N00347
—
SC
Enumeration date
12/05/2005
Last updated
07/15/2010
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