Individual
DR. KISHA ROCHELLE YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4105 MATTHEWS MINT HILL RD, MINT HILL, NC 28105-3633
(704) 384-9920
(704) 384-9925
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-9920
(704) 384-9925
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
134137
NC
207Q00000X
Family Medicine Physician
Primary
200701684
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
134137
MD LIMITED TRAINING LIC
NC
05
—
5912253
—
NC
Enumeration date
03/02/2007
Last updated
03/07/2023
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