Provider Demographics
NPI:1972598522
Name:HUNT, KERRY EDMUND (MD)
Entity Type:Individual
Prefix:
First Name:KERRY
Middle Name:EDMUND
Last Name:HUNT
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 1:3320 EXECUTIVE DR 111
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7445
Mailing Address - Country:US
Mailing Address - Phone:919-876-2427
Mailing Address - Fax:919-790-8423
Practice Address - Street 1:3320 EXECUTIVE DR STE 111
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7445
Practice Address - Country:US
Practice Address - Phone:919-876-2427
Practice Address - Fax:919-944-0085
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200700416207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5907407Medicaid
VA1972598522Medicaid
NC2070403Medicare PIN