Bullard, Kenneth Penn

Bullard, Kenneth Penn is an individual health care provider with primary practice located at 1225 Charter Place , Charlotte NC 28211-5503. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as his primary health care specialty. Bullard, Kenneth Penn can be contacted via phone (704) 364-2358.

Contact Information

Primary practice address
1225 Charter Place Charlotte NC 28211-5503
Phone: (704) 364-2358
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 15028 North Carolina

Profile Details

NPI number 1851452296
LBN Legal business name Bullard, Kenneth Penn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 12th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851452296 NPPES
North Carolina Other 19723 BLUE CROSS BLUE SHIELD
North Carolina MEDICAID 360677 BLUE CROSS BLUE SHIELD
North Carolina MEDICAID 8919723 BLUE CROSS BLUE SHIELD

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