Provider Demographics
NPI:1063462729
Name:OSSEY, KEVIN D (MD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:D
Last Name:OSSEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3625 N ELM ST
Mailing Address - Street 2:SUITE 110A
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-2604
Mailing Address - Country:US
Mailing Address - Phone:336-282-4840
Mailing Address - Fax:336-282-4840
Practice Address - Street 1:3625 N ELM ST
Practice Address - Street 2:SUITE 110A
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27455-2604
Practice Address - Country:US
Practice Address - Phone:336-282-4840
Practice Address - Fax:336-282-4840
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC28294207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5714745Medicaid
NC8964289Medicaid
NC64289OtherBCBS
VA5714745Medicaid
NC64289OtherBCBS