Nicole Ludmil Ivanov, MD
Pediatrics in Charlotte, NC. Individual provider (NPI-1).
NPI number1003376534
StatusActive
Last updated in NPPESJul 15, 2024
Details
- NPI
- 1003376534
- Entity type
- Individual (NPI-1)
- Name
- Nicole Ludmil Ivanov
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 21, 2019
- Certification date
- Jul 28, 2022
- Last updated
- Jul 15, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | 2022-01947 | NC | Yes |
Practice location
9908 Couloak DrSte 103
Charlotte, NC 28216-8678
Phone 704-801-2025
Mailing address
Po Box 19305Charlotte, NC 28219-9305
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