Provider Demographics
NPI:1457395816
Name:KALIL, DARRYL ALFRED (MD)
Entity Type:Individual
Prefix:
First Name:DARRYL
Middle Name:ALFRED
Last Name:KALIL
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 1:624 QUAKER LN
Mailing Address - Street 2:STE. 207C
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-3832
Mailing Address - Country:US
Mailing Address - Phone:336-883-2500
Mailing Address - Fax:
Practice Address - Street 1:306 WESTWOOD AVE
Practice Address - Street 2:STE 401
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-4342
Practice Address - Country:US
Practice Address - Phone:336-885-6168
Practice Address - Fax:336-885-6402
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC97-00999207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP00829432OtherRR MEDICARE
NC891056FMedicaid
NC990004554OtherRR MEDICARE
NCP00829432OtherRR MEDICARE
NC891056FMedicaid
NC2239774BMedicare PIN