Individual
KEITH CHRISTIAN RESCHLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
240 HOSPITAL DR NE, BOLIVIA, NC 28422-8346
(910) 721-2070
(107) 212-0749
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(910) 721-2070
(910) 721-2074
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
32841
NC
208M00000X
Hospitalist Physician
32841
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8971288
—
NC
Enumeration date
06/29/2005
Last updated
10/25/2020
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