GENESIS ENT & PLASTIC SURGERY PLLC NPI 1366484958

NPI Information

NPI: 1366484958
Provider Name: GENESIS ENT & PLASTIC SURGERY, PLLC
Classification: Otolaryngology - 207YX0905X
Entity Type: Organization

Specialization: Otolaryngology/Facial Plastic Surgery

Address:
14835 JOHN J DELANEY DR
SUITE 210
CHARLOTTE, NC
ZIP 28277
Phone: (704) 544-1300
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GENESIS ENT & PLASTIC SURGERY, PLLC is an otolaryngology/facial plastic surgery otolaryngology in Charlotte, NC. The provider is an otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. GENESIS ENT & PLASTIC SURGERY, PLLC NPI is 1366484958. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

14835 JOHN J DELANEY DR
SUITE 210
CHARLOTTE, NC
ZIP 28277-738
Phone: (704) 544-1300
Fax: (704) 544-2765

The provider's authorized official is Henry Ford .
The authorized official title is Administrator and has the following contact phone number (704) 544-1300.

The enumeration date for this NPI number is 6/11/2006 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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207YX0905X	Otolaryngology	Otolaryngology/Facial Plastic Surgery	9700531	NORTH CAROLINA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	191722	MEDICAID	NORTH 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

NPI Synchronization or Removal

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