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General NPI Number Information
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NPI Number | 1053313064
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Entity Type | Individual
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Provider Name | KIMBERLY WELTY MCDONALD MD
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Gender | Female
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Dates
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Enumeration Date | 08/10/2005
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Last Update Date | 12/03/2021
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Provider Practice Location Address
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Address Line | 2034 CREEKSIDE LANDING DR
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City | APEX
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State | NC
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Zip | 27502-3982
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Country | US
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Telephone | 252-717-7291
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Fax |
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Provider Business Mailing Address
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Address Line | 2515 ANDERSON DR
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City | RALEIGH
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State | NC
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Zip | 27608-1407
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Country | US
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Telephone | 252-717-7291
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | 2005-01324
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 2005-01324
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License Number State | NC
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