Individual
BARBARA ELIZABETH KISSAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1900 RANDOLPH RD, SUITE 1010, CHARLOTTE, NC 28207-1122
(704) 316-1155
(704) 316-1160
Mailing address
100 KIMEL FOREST DR, WINSTON SALEM, NC 27103-6074
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
2006-01118
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32568300
—
WI
Enumeration date
09/12/2005
Last updated
03/02/2026
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