Provider Demographics
NPI:1457301889
Name:DYAL, KAMAL (MD)
Entity Type:Individual
Prefix:
First Name:KAMAL
Middle Name:
Last Name:DYAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1918 WATERFORD VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:CLEMMONS
Mailing Address - State:NC
Mailing Address - Zip Code:27012-9381
Mailing Address - Country:US
Mailing Address - Phone:704-638-9000
Mailing Address - Fax:704-638-3847
Practice Address - Street 1:WILLIAM B HEFNERVAMC
Practice Address - Street 2:1601 BRENNER AVENUE
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-9381
Practice Address - Country:US
Practice Address - Phone:704-638-9000
Practice Address - Fax:704-638-3847
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD 26883207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine