Provider Demographics
NPI:1225064249
Name:MUNRO, KIMBERLY CARMEN (MD)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:CARMEN
Last Name:MUNRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 COTTEN LN STE 1
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-8415
Mailing Address - Country:US
Mailing Address - Phone:919-235-6456
Mailing Address - Fax:
Practice Address - Street 1:101 COTTEN LN STE 1
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-8415
Practice Address - Country:US
Practice Address - Phone:919-235-6456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY220732207V00000X
NC2017-00876207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYKM08952410Medicaid
NYKM08952410Medicaid
NYH56945Medicare UPIN