Ballantyne Emergency Physicians PLLC
Emergency Medicine in Charlotte, NC. Organization (NPI-2).
NPI number1164052726
StatusActive
Last updated in NPPESJun 17, 2020
Details
- NPI
- 1164052726
- Entity type
- Organization (NPI-2)
- Legal business name
- Ballantyne Emergency Physicians PLLC
- Organization subpart
- No
- Enumeration date
- Jan 23, 2020
- Certification date
- Jun 17, 2020
- Last updated
- Jun 17, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207P00000X | Emergency Medicine | – | – | Yes |
Practice location
11516 Providence RdCharlotte, NC 28277-2691
Phone 704-667-0370
Mailing address
5665 New Northside Dr Ste 320Atlanta, GA 30328-5834
Phone 770-874-5400
Authorized official
Kim H Larsen
Director Of Credentialing
7708745400
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