Provider Demographics
NPI:1912949462
Name:BILLMIRE, KAREN LEIGH (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:LEIGH
Last Name:BILLMIRE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 PEE DEE AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28001-4932
Mailing Address - Country:US
Mailing Address - Phone:704-986-1500
Mailing Address - Fax:
Practice Address - Street 1:110 W WALKER AVE
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-6760
Practice Address - Country:US
Practice Address - Phone:336-633-7000
Practice Address - Fax:336-625-3817
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC302892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8915690Medicaid
NC30289OtherNC LICENSE
NCD92632Medicare UPIN
NC280002Medicare ID - Type Unspecified