| Carolinas Pediatric Neurology Care-ballantyne | |
|
12311 Copper Way Suite 200-a Charlotte NC 28277-3642 | |
| (704) 403-2660 | |
| (704) 403-2670 |
| Full Name | Carolinas Pediatric Neurology Care-ballantyne |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology With Special Qualifications In Child Neurology |
| Location | 12311 Copper Way, Charlotte, North Carolina |
| Authorized Official Name and Position | Frieda Miller Lowder (SR VICE PRESIDENT) |
| Authorized Official Contact | 7044031780 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolinas Pediatric Neurology Care-ballantyne 12311 Copper Way Suite 200-a Charlotte NC 28277-3642 Ph: (704) 403-2660 | Carolinas Pediatric Neurology Care-ballantyne 12311 Copper Way Suite 200-a Charlotte NC 28277-3642 Ph: (704) 403-2660 |
| NPI Number | 1023415981 |
|---|---|
| Provider Enumeration Date | 11/20/2014 |
| Last Update Date | 11/20/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023415981 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0402X | Psychiatry & Neurology - Neurology With Special Qualifications In Child Neurology | (* (Not Available)) | Primary |
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