Individual
KRISTI DESHANNON ABBOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
136 GATEWAY BLVD STE A, MOORESVILLE, NC 28117-5608
(704) 799-2878
(704) 799-1627
Mailing address
136 GATEWAY BLVD STE A, MOORESVILLE, NC 28117-5608
(704) 799-2878
(704) 799-1627
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2009-00630
NC
2080A0000X
Pediatric Adolescent Medicine Physician
2009-00630
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457489973
—
NC
05
—
5912736
—
NC
05
—
NC1018
—
SC
Enumeration date
02/28/2007
Last updated
08/31/2015
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