Provider Demographics
NPI:1225098023
Name:KILFOIL, MARY MARTHA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:MARTHA
Last Name:KILFOIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 27877
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0877
Mailing Address - Country:US
Mailing Address - Phone:919-966-8279
Mailing Address - Fax:919-966-8796
Practice Address - Street 1:712 FLEMING ST
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791
Practice Address - Country:US
Practice Address - Phone:828-698-3301
Practice Address - Fax:828-698-7113
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC9401431207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP00988445OtherRR MEDICARE
NC894893KMedicaid
NC894893KMedicaid
NC2207838FMedicare PIN