Provider Demographics
NPI:1487674487
Name:KING, ANNE B (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:B
Last Name:KING
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 1:520 S VAN BUREN RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:EDEN
Mailing Address - State:NC
Mailing Address - Zip Code:27288-5201
Mailing Address - Country:US
Mailing Address - Phone:336-627-5437
Mailing Address - Fax:336-627-1681
Practice Address - Street 1:520 S VAN BUREN RD
Practice Address - Street 2:SUITE 2
Practice Address - City:EDEN
Practice Address - State:NC
Practice Address - Zip Code:27288-5201
Practice Address - Country:US
Practice Address - Phone:336-627-5437
Practice Address - Fax:336-627-1681
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC25863208000000X
WI49224208000000X
WAMD00046379208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890147XMedicaid
NC8949023Medicaid
NC8949023Medicaid