Kipreos, Nicholas Theophilos

Kipreos, Nicholas Theophilos is an individual health care provider with primary practice located at 865 W Lake Dr , Mount Airy NC 27030-2157. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Kipreos, Nicholas Theophilos can be contacted via phone (336) 719-6100.

Contact Information

Primary practice address
865 W Lake Dr Mount Airy NC 27030-2157
Phone: (336) 719-6100
Fax: (336) 719-2313
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0101049407 Virginia
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 2016-00121 North Carolina

Profile Details

NPI number 1104825926
LBN Legal business name Kipreos, Nicholas Theophilos
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2005
Last updated Jun 23rd, 2022 - about 4 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 1104825926 NPPES
Virginia MEDICAID 005614236

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