Provider Demographics
NPI:1023094026
Name:KILDE, JOHN D (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:KILDE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1908 HILCO ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28001-6388
Mailing Address - Country:US
Mailing Address - Phone:704-983-5350
Mailing Address - Fax:704-983-5370
Practice Address - Street 1:1908 HILCO ST
Practice Address - Street 2:SUITE A
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-6387
Practice Address - Country:US
Practice Address - Phone:704-983-5350
Practice Address - Fax:704-983-5370
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NCNC200300630207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89134PGMedicaid
NC134PGOtherBCBSNC
SCQ0063YOtherMEDICAID-SC
NCP01370658OtherMEDICARE RAILROAD
NC9328154OtherCIGNA
NCP01370658OtherMEDICARE RAILROAD
H85215Medicare UPIN