Provider Demographics
NPI:1932267176
Name:VERECZKEY, KINGA M (MD)
Entity Type:Individual
Prefix:DR
First Name:KINGA
Middle Name:M
Last Name:VERECZKEY
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 1:143 W FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-2539
Mailing Address - Country:US
Mailing Address - Phone:919-966-4996
Mailing Address - Fax:919-843-5515
Practice Address - Street 1:1301 CENTRAL DR
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-4159
Practice Address - Country:US
Practice Address - Phone:919-966-4996
Practice Address - Fax:919-843-5515
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2002-00619207R00000X
NC200200619207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89133ANMedicaid
NCH61633Medicare UPIN
NC2036146Medicare ID - Type Unspecified