Fedoriw, Kelly Bossenbroek
Fedoriw, Kelly Bossenbroek is an individual health care provider with primary practice located at 590 Manning Dr , Chapel Hill NC 27599-6119. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Fedoriw, Kelly Bossenbroek can be contacted via phone (919) 966-0210.Contact Information
Primary practice address
590 Manning Dr
Chapel Hill NC 27599-6119
Phone: (919) 966-0210
Fax: (919) 966-2126
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 2008-01856 | North Carolina |
Profile Details
| NPI number | 1285674606 |
|---|---|
| LBN Legal business name | Fedoriw, Kelly Bossenbroek |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 7th, 2006 |
| Last updated | Mar 31st, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285674606 | NPPES |
| Connecticut | MEDICAID | 004236346 |
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