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Individual

DR. KENNETH RICHARD KOHAGEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2417 ATRIUM DR, SUITE 150, RALEIGH, NC 27607-6673
(919) 791-2040
(919) 791-2041
Mailing address
2417 ATRIUM DR, SUITE 150, RALEIGH, NC 27607-6673
(919) 791-2040
(919) 791-2041

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
94-00546
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100014396
RAILROAD MEDICARE
NC
01
289330
MAMSI
NC
01
2950429
UNITED
NC
01
30622
PARTNERS
NC
01
4510878
AETNA
NC
01
49984
BCBS
NC
01
6013465
CIGNA
NC
05
8949984
NC
01
94963
MEDCOST
NC
Enumeration date
12/21/2005
Last updated
07/15/2010
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