Provider Demographics
NPI:1306896592
Name:ASHKIN, KENNETH TODD (MD)
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:TODD
Last Name:ASHKIN
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 1:10009 PARK CEDAR DR
Mailing Address - Street 2:STE 100
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-8935
Mailing Address - Country:US
Mailing Address - Phone:704-412-7859
Mailing Address - Fax:833-973-4534
Practice Address - Street 1:10009 PARK CEDAR DR STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-8935
Practice Address - Country:US
Practice Address - Phone:704-541-4240
Practice Address - Fax:833-973-4534
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0365302084S0012X
NC94007052084N0400X
NC7052084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8912077Medicaid
F45621Medicare UPIN
NC8912077Medicaid