Vanderhave, Kelly L

Vanderhave, Kelly L is an individual health care provider with primary practice located at 1025 Morehead Medical Drive Suite 300, Charlotte NC 28204-2966. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is her primary health care specialty. Vanderhave, Kelly L can be contacted via phone (704) 355-5982.

Contact Information

Primary practice address
1025 Morehead Medical Drive Suite 300 Charlotte NC 28204-2966
Phone: (704) 355-5982
Fax: (704) 355-5984
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 2012-02054 North Carolina
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 4301069717 Michigan
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 2012-02054 North Carolina

Profile Details

NPI number 1053375170
LBN Legal business name Vanderhave, Kelly L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 14th, 2006
Last updated Jun 3rd, 2019 - about 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053375170 NPPES
North Carolina MEDICAID 1053375170
North Carolina MEDICAID 5922062
North Carolina MEDICAID NC1738

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