| Memory & Movement Charlotte | |
|
411 Billingsley Rd Ste 103 Charlotte NC 28211-1066 | |
| (704) 577-3186 | |
| (704) 626-2701 |
| Full Name | Memory & Movement Charlotte |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 411 Billingsley Rd Ste 103, Charlotte, North Carolina |
| Authorized Official Name and Position | Sanjay S Iyer (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7045773186 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Memory & Movement Charlotte 411 Billingsley Rd Ste 103 Charlotte NC 28211-1066 Ph: (704) 577-3186 | Memory & Movement Charlotte 411 Billingsley Rd Ste 103 Charlotte NC 28211-1066 Ph: (704) 577-3186 |
| NPI Number | 1508394750 |
|---|---|
| Provider Enumeration Date | 06/01/2017 |
| Last Update Date | 01/09/2024 |
| Certification Date | 01/04/2024 |
| Medicare PECOS PAC ID | 7214205277 |
|---|---|
| Medicare Enrollment ID | O20170615000272 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508394750 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Charles H Edwards |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1821071523 PECOS PAC ID: 7012804008 Enrollment ID: I20040303000934 |
| Provider Name | Aristides E Chaconas |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1710954359 PECOS PAC ID: 7214918044 Enrollment ID: I20040527000691 |
| Provider Name | Sanjay Shyam Iyer |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1376561472 PECOS PAC ID: 7416933072 Enrollment ID: I20061017000287 |
| Provider Name | Swatiben Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508177437 PECOS PAC ID: 9335324920 Enrollment ID: I20110425000853 |
| Provider Name | Anita T Wu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1558399691 PECOS PAC ID: 9830151208 Enrollment ID: I20110517000866 |
| Provider Name | Heather Ann Braucher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841523479 PECOS PAC ID: 7911035639 Enrollment ID: I20190320003196 |
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