Individual
KEVIN C ADDISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
171 FAIRVIEW RD, MOORESVILLE, NC 28117-9500
(704) 660-4390
(704) 660-4399
Mailing address
171 FAIRVIEW RD, MOORESVILLE, NC 28117-9500
(704) 660-4390
(704) 660-4399
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
2006-00447
NC
208M00000X
Hospitalist Physician
0101272440
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5904803
—
NC
Enumeration date
07/13/2006
Last updated
08/31/2021
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