| Doctor Name: | DR. ANDREW M KELLERMANN |
| NPI Number: | 1871756122 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | DO0000001965 |
| Business Practice Address: | 1333 S Dickinson Dr Suite 240 Leland, NC - 284516430 |
| Business Phone Number: | 7045124808 |
| Business Fax Number: | 7045124838 |
| Mailing Address: | 1333 S Dickinson Dr, Suite 240 LELAND |
| State: | NC |
| Postal Code: | 284516430 |
| Phone Number: | 7045124808 |
| Fax Number: | 7045124838 |
| NPI Enumeration Date: | 07/08/2008 |
| NPI Last Update Date: | 05/18/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | DO0000001965 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |