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Organization
REVELSTONE FAMILY PRACTICE
Active
Organization
REVELSTONE FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD ALLEN KEPP MD (OWNER)
(704) 986-3900
Entity
Organization
Contact information
Practice address
232 CONCORD RD, ALBEMARLE, NC 28001-4612
(704) 986-3900
(704) 986-3913
Mailing address
232 CONCORD RD, ALBEMARLE, NC 28001-4612
(704) 986-3900
(704) 986-3913
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
9400873
NC
207Q00000X
Family Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LW0102X
Women's Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8947986
—
NC
Enumeration date
02/09/2016
Last updated
03/17/2021
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