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CHARLOTTE MINIMALLY INVASIVE SURGICAL ASSOCIATES PLLC NPI 1033141817


NPI Information

NPI: 1033141817
Provider Name: CHARLOTTE MINIMALLY INVASIVE SURGICAL ASSOCIATES PLLC

Doing Business As: THE CHARLOTTE COMPREHENSIVE WEIGHT MANAGEMENT CENTER

Classification: Surgery - 2086S0129X
Entity Type: Organization

Specialization: Vascular Surgery

Address:
330 BILLINGSLEY ROAD
SUITE 210
CHARLOTTE, NC
ZIP 28211
Phone: (704) 940-0715
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CHARLOTTE MINIMALLY INVASIVE SURGICAL ASSOCIATES PLLC is a vascular surgery surgery in Charlotte, NC. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. CHARLOTTE MINIMALLY INVASIVE SURGICAL ASSOCIATES PLLC NPI is 1033141817. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As The Charlotte Comprehensive Weight Management Center.

The provider's business location address is:

330 BILLINGSLEY ROAD
SUITE 210
CHARLOTTE, NC
ZIP 28211
Phone: (704) 940-0715
Fax: (704) 940-0732

The provider's authorized official is Omar K Danner .
The authorized official title is Physician Owner and has the following contact phone number (704) 940-0715.

The enumeration date for this NPI number is 7/6/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12086S0129XSurgeryVascular SurgeryNORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
15901378MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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