Provider Demographics
NPI:1013088350
Name:KAHN, KEVIN A (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:A
Last Name:KAHN
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 1:6114 FAYETTEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-6284
Mailing Address - Country:US
Mailing Address - Phone:919-942-4424
Mailing Address - Fax:919-942-4440
Practice Address - Street 1:6114 FAYETTEVILLE RD STE 109
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6284
Practice Address - Country:US
Practice Address - Phone:919-942-4424
Practice Address - Fax:919-942-4440
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC96009632084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8947708Medicaid
NC8947708Medicaid