Individual
KEVIN WALLACE LOBDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1025 MOREHEAD MEDICAL DR, STE 300, CHARLOTTE, NC 28204-2963
(704) 355-1813
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
200400906
NC
2086S0102X
Surgical Critical Care Physician
200400906
NC
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
200400906
NC
Other
Enumeration date
07/26/2006
Last updated
07/15/2024
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