Celeste Neurology | |
5500 Executive Center Dr Ste 206 Charlotte NC 28212-8864 | |
(984) 777-9940 | |
(877) 794-5929 |
Full Name | Celeste Neurology |
---|---|
Speciality | Psychiatry & Neurology |
Location | 5500 Executive Center Dr Ste 206, Charlotte, North Carolina |
Authorized Official Name and Position | Sumul Modi (OWNER/PARTNER) |
Authorized Official Contact | 9847779940 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Celeste Neurology 5500 Executive Center Dr Ste 206 Charlotte NC 28212-8864 Ph: (984) 777-9940 | Celeste Neurology 5500 Executive Center Dr Ste 206 Charlotte NC 28212-8864 Ph: (984) 777-9940 |
NPI Number | 1013642776 |
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Provider Enumeration Date | 07/18/2022 |
Last Update Date | 12/02/2023 |
Certification Date | 12/02/2023 |
Medicare PECOS PAC ID | 2567837818 |
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Medicare Enrollment ID | O20230419000244 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013642776 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
Provider Name | Sumul Yogeshkumar Modi |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1033466776 PECOS PAC ID: 5294958492 Enrollment ID: I20191022000035 |
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