CAROLINA AESTHETIC AND RECONSTRUCTIVE SURGERY PLLC NPI 1306168497

NPI Information

  • NPI: 1306168497
  • Provider Name: CAROLINA AESTHETIC AND RECONSTRUCTIVE SURGERY, PLLC
  • Classification: Clinic/Center - 261QM2500X
  • Specialization: Medical Specialty
  • Entity Type: Organization
  • Address: 1918 RANDOLPH RD
    SUITE 550
    CHARLOTTE, NC
    ZIP 28207
  • Phone: (704) 375-6766

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NPI Details

CAROLINA AESTHETIC AND RECONSTRUCTIVE SURGERY, PLLC is a medical specialty clinic center in Charlotte, NC. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). CAROLINA AESTHETIC AND RECONSTRUCTIVE SURGERY, PLLC NPI is 1306168497. The provider is registered as an organization entity type.

The provider's business location address is:

1918 RANDOLPH RD
SUITE 550
CHARLOTTE, NC
ZIP 28207-100
Phone: (704) 375-6766
Fax: (704) 332-6552

The provider's authorized official is Maria B Honnebier .
The authorized official title is Director and has the following contact phone number (704) 375-6766.

The enumeration date for this NPI number is 2/17/2010 and was last updated on 2/17/2010.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM2500XClinic/CenterMedical Specialty200800118NORTH CAROLINAYes

What is NPI?

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This page was last updated on: 11/21/2025

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