Michael Roden, PA-C
Physician Assistant in Charlotte, NC. Individual provider (NPI-1).
NPI number1669980314
StatusActive
Last updated in NPPESJan 11, 2022
Details
- NPI
- 1669980314
- Entity type
- Individual (NPI-1)
- Name
- Mr. Michael Roden
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 16, 2018
- Certification date
- Jan 11, 2022
- Last updated
- Jan 11, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 021749 | NY | Yes |
Practice location
225 Baldwin AveCharlotte, NC 28204-3109
Phone 704-376-1605
Mailing address
225 Baldwin AveCharlotte, NC 28204-3109
Phone 704-376-1605
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