Maxwell, Kenneth Scruggs
Maxwell, Kenneth Scruggs is an individual health care provider with primary practice located at 110 Charlois Blvd , Winston Salem NC 27103-1522. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Maxwell, Kenneth Scruggs can be contacted via phone (336) 768-3361.Contact Information
Primary practice address
110 Charlois Blvd
Winston Salem NC 27103-1522
Phone: (336) 768-3361
Fax: (336) 768-4131
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | 9500660 | North Carolina |
Profile Details
| NPI number | 1801876768 |
|---|---|
| LBN Legal business name | Maxwell, Kenneth Scruggs |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 18th, 2006 |
| Last updated | Feb 15th, 2012 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1801876768 | NPPES |
| North Carolina | MEDICAID | 8955051 | |
| North Carolina | Other | 040015067 | |
| North Carolina | Other | 55051 | |
| North Carolina | Other | 54268 | |
| North Carolina | Other | 6502393 | |
| North Carolina | Other | 9881 | |
| North Carolina | Other | 1001971 |
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