Individual provider · NPI-1

Cameron Wade Beatty

Contractor · Charlotte, NC

NPI number1467127779
StatusActive
Last updated in NPPESAug 10, 2021

Details

NPI
1467127779
Entity type
Individual (NPI-1)
Name
Mr. Cameron Wade Beatty
Sex
Male
Sole proprietor
No
Enumeration date
Aug 10, 2021
Certification date
Aug 10, 2021
Last updated
Aug 10, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
171W00000X Contractor–NCYes

Practice location

2310 Juneberry Ct
Charlotte, NC 28216-3284

Phone 704-562-8170

Mailing address

2310 Juneberry Ct
Charlotte, NC 28216-3284

Phone 704-562-8170

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