Provider Demographics
NPI:1003072000
Name:MILLS, KYLE CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:KYLE
Middle Name:CHARLES
Last Name:MILLS
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:PO BOX 63126
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28263-3126
Mailing Address - Country:US
Mailing Address - Phone:800-475-6112
Mailing Address - Fax:706-653-4449
Practice Address - Street 1:509 BILTMORE AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4601
Practice Address - Country:US
Practice Address - Phone:828-213-1111
Practice Address - Fax:706-653-4449
Is Sole Proprietor?:No
Enumeration Date:2008-07-30
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.35819207ZD0900X
NC2012-00340207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810023239Medicaid
SCQ40013Medicaid
VA1003072000Medicaid
WV3810023239Medicaid