Provider Demographics
NPI:1386923373
Name:KUIC, SIMEON M (D C)
Entity type:Individual
Prefix:
First Name:SIMEON
Middle Name:M
Last Name:KUIC
Suffix:
Gender:M
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 ZONNA COURT
Mailing Address - Street 2:
Mailing Address - City:CANDLER
Mailing Address - State:NC
Mailing Address - Zip Code:28715-8993
Mailing Address - Country:US
Mailing Address - Phone:828-216-4182
Mailing Address - Fax:
Practice Address - Street 1:22 BATTERY PARK AVENUE
Practice Address - Street 2:# 212-A
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2715
Practice Address - Country:US
Practice Address - Phone:828-216-4182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-09
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4088111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5918736Medicaid
NCNC2917AMedicare PIN