Basic Information
| Provider Information | |||||||||
| NPI: | 1205804986 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHEEK | ||||||||
| FirstName: | VINCENT | ||||||||
| MiddleName: | KILMER | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2000 PERIMETER PARK DR STE 200 | ||||||||
| Address2: | |||||||||
| City: | MORRISVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275608442 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9842154110 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 401 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | KENANSVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283498801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9102962774 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2006 | ||||||||
| LastUpdateDate: | 05/25/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 05/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 28404 | NC | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 0101041661 | VA | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207P00000X | 0101041661 | VA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 28404 | NC | N | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | AC2980971 | 01 | DEA | OTHER | 28404 | 01 | NC | MEDICAL BOARD | OTHER | 8911597 | 05 | NC | MEDICAID |