Provider Demographics
NPI:1265425391
Name:MIAO, KAI (MD)
Entity type:Individual
Prefix:
First Name:KAI
Middle Name:
Last Name:MIAO
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:PO BOX 602463
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2463
Mailing Address - Country:US
Mailing Address - Phone:252-633-8000
Mailing Address - Fax:252-635-6951
Practice Address - Street 1:2310 ERWIN RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0001
Practice Address - Country:US
Practice Address - Phone:919-862-5237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2001001101207R00000X
NC20101101208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC129JAOtherBLUE CROSS
NC89129JAMedicaid
H42481Medicare UPIN
NC129JAOtherBLUE CROSS
NC2290339BMedicare PIN