Provider Demographics
NPI:1558565358
Name:CARMEN, KEVIN PATRICK (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:PATRICK
Last Name:CARMEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 2ND AVE SW
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-2545
Mailing Address - Country:US
Mailing Address - Phone:828-327-6026
Mailing Address - Fax:330-588-8605
Practice Address - Street 1:1109 2ND AVE SW
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-2545
Practice Address - Country:US
Practice Address - Phone:828-327-6026
Practice Address - Fax:828-327-8796
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.098114207P00000X, 2084P0800X
MDD70363207P00000X
NC1419862084A0401X
KYTP8782084P0800X
VA01012805362084P0800X
390200000X
CODR.00594462084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program