Individual
MARIAH MANN MCKELLAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
303 GREEN ST E, WILSON, NC 27893-4105
(252) 243-9800
Mailing address
303 GREEN ST E, WILSON, NC 27893-4105
(252) 243-9800
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2013-00178
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073315
UNITED HEALTH CARE
NC
05
—
1760702815
—
NC
01
—
18079
BCBS OF NC
NC
01
—
247301
MEDCOST
NC
01
—
4802912
AETNA
NC
01
—
NCD002A
MEDICARE
NC
Enumeration date
06/10/2010
Last updated
07/21/2022
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