Provider Demographics
NPI:1922399930
Name:HOUNNOU, ANATOLE (DO)
Entity Type:Individual
Prefix:DR
First Name:ANATOLE
Middle Name:
Last Name:HOUNNOU
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:336-564-4866
Mailing Address - Fax:336-277-6815
Practice Address - Street 1:1750 KERNERSVILLE MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-7146
Practice Address - Country:US
Practice Address - Phone:336-564-4866
Practice Address - Fax:336-277-6815
Is Sole Proprietor?:No
Enumeration Date:2011-04-25
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY258868207Q00000X
NC201500885207Q00000X
NC2015-00885208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine