Individual
THOMAS CLARK KELLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 ROBINHOOD MEDICAL PLZ, WINSTON SALEM, NC 27106-5471
(336) 718-7950
(336) 718-7989
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2025-02829
NC
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
2025-02829
NC
207QS0010X
Sports Medicine (Family Medicine) Physician
35.143319
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0459528
—
OH
Enumeration date
04/24/2017
Last updated
08/22/2025
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