Individual
DR. KELLY LYNNE BARHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
108 DORNACH WAY, ADVANCE, NC 27006-7305
(336) 940-2407
(336) 940-2409
Mailing address
108 DORNACH WAY, ADVANCE, NC 27006-7305
(336) 940-2407
(336) 940-2409
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2007-00971
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14501
BLUE CROSS BLUE SHIELD OF NORTH CAROLINA
NC
05
—
5907303
—
NC
Enumeration date
06/14/2007
Last updated
02/02/2010
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