Mid-Charlotte Dermatology And Research PLLC
Dermatology in Charlotte, NC. Organization (NPI-2).
NPI number1497940944
StatusActive
Last updated in NPPESMar 1, 2022
Details
- NPI
- 1497940944
- Entity type
- Organization (NPI-2)
- Legal business name
- Mid-Charlotte Dermatology And Research PLLC
- Organization subpart
- No
- Enumeration date
- Sep 7, 2007
- Certification date
- Mar 1, 2022
- Last updated
- Mar 1, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207N00000X | Dermatology | 23521 | NC | Yes |
| 207R00000X | Internal Medicine | 23521 | NC | |
| 208000000X | Pediatrics | 23521 | NC |
Other names
- Southeast Vulvar Clinic (Other Name)
Practice location
6406 Carmel Rd Ste 309Charlotte, NC 28226-8267
Phone 704-367-9777 · Fax 704-367-0504
Mailing address
6406 Carmel Rd Ste 309Charlotte, NC 28226-8267
Phone 704-367-9777 · Fax 704-367-0504
Authorized official
Irene Elizabeth Edwards
Owner
7043679777
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