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Individual

DR. KEVIN DAVID WELLBAUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
133 WELTON WAY STE C, MOORESVILLE, NC 28117-9163
(704) 664-2552
(704) 664-5382
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(844) 266-8268

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
074135
GA
208000000X
Pediatrics Physician
Primary
2016-01403
NC
208000000X
Pediatrics Physician
5536
GA

Other

Enumeration date
06/26/2012
Last updated
11/13/2025
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