Provider Demographics
NPI:1982644035
Name:KENT, STEVEN M (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:M
Last Name:KENT
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 1:205 PAGE RD
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-8798
Mailing Address - Country:US
Mailing Address - Phone:910-295-5511
Mailing Address - Fax:
Practice Address - Street 1:205 PAGE RD
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8798
Practice Address - Country:US
Practice Address - Phone:910-295-5511
Practice Address - Fax:910-235-3428
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006-00045207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2501778OtherEVERCARE
NC142FUOtherBC/BS NC PROVIDER#
NC189316OtherMEDCOST PROVIDER#
SCN45006OtherSC MEDICAID PROV#
NCP00336932OtherPALMETTO GOVT SERVICES
NC192092OtherMEDCOST
NC5903717Medicaid
NCFH2967275OtherFIRSTCAROLINACARE PROV#
NCP00343709OtherPALMETTO GOVT SERVICES
NCP00343709OtherPALMETTO GOVT SERVICES
NCP00336932OtherPALMETTO GOVT SERVICES
NC189316OtherMEDCOST PROVIDER#