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Specialty details in registry · Charlotte, NC

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At a glance

2100 South Blvd Apt 4345, Charlotte, NC 28203-6731

NPPES record updated Jul 9, 2025. Public records can lag behind changes at a practice.

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  • Are you accepting new patients?
  • Do you accept my specific insurance plan?
  • Do you provide the service I need at this address?
  • Do I need a referral, and what is the earliest appointment?

Insurance participation and appointment availability are not established by these public records.

Practice location

2100 South Blvd Apt 4345
Charlotte, NC 28203-6731
Professional details: NPI, taxonomy & registry record
NPI1588553549
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Registry details

Primary taxonomy
Specialty details in registry
Taxonomy code
320800000X
Enumeration date
Jul 2, 2025
Record updated
Jul 9, 2025
More registry details
Provider type
Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

320800000X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

2100 South Blvd Apt 4345
Charlotte, NC 28203-6731
Phone
(940) 230-3887
Mailing address
2100 SOUTH BLVD APT 4345

CHARLOTTE, NC 282036731
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

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