Provider Demographics
NPI:1699728170
Name:WINTER, KENNETH HOWE (MD)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:HOWE
Last Name:WINTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1317 ELM STREET
Mailing Address - Street 2:SUITE 1 B
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1023
Mailing Address - Country:US
Mailing Address - Phone:336-274-4285
Mailing Address - Fax:336-482-2177
Practice Address - Street 1:1317 N ELM ST
Practice Address - Street 2:SUITE 1B
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1023
Practice Address - Country:US
Practice Address - Phone:336-274-4285
Practice Address - Fax:336-482-2177
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC208622085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC73487OtherMEDCOST
NC1600283OtherUNITED HEALTHCARE
NC24731OtherPARTNERS
NC300085691OtherRAILROAD MEDICARE
NC88591OtherBCBS
NC8988591Medicaid
NCC82458Medicare UPIN
NC8988591Medicaid