Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208D00000X | General Practice Physician | 2005-01324 | NC |
NPI | 1053313064 |
---|---|
Provider Name | Dr. Kimberly Welty Mcdonald |
First Address | Raleigh, NC 27608-1407 |
Second Address | Apex, NC 27502-3982 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2005 |
Last Update Date | 03/12/2021 |