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Individual

DR. KELLI MARIE YOUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
2095 HENRY TECKLENBURG DR, CHARLESTON, SC 29414-5733
(843) 402-1037
(843) 402-1295
Mailing address
PO BOX 602645, CHARLOTTE, NC 28260-2645
(843) 789-1620
(843) 724-2454

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
39231
SC
207P00000X
Emergency Medicine Physician
OT013177
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
392319
SC
Enumeration date
06/29/2009
Last updated
12/07/2020
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