PEACH STATE MEDICAL PRACTICE PC NPI 1801544093

NPI Information

  • NPI: 1801544093
  • Provider Name: PEACH STATE MEDICAL PRACTICE, PC
  • Classification: Obstetrics & Gynecology - 207VE0102X
  • Specialization: Reproductive Endocrinology
  • Entity Type: Organization
  • Doing Business As: KINDBODY OF NC MEDICAL PRACTICE, PC
  • CLIA Number: 34D2312489
  • Address: 420 PROVIDENCE RD
    CHARLOTTE, NC
    ZIP 28207
  • Phone: (855) 563-2639

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NPI Details

PEACH STATE MEDICAL PRACTICE, PC is a reproductive endocrinology obstetrics gynecology in Charlotte, NC. The provider is an obstetrician/gynecologist who is capable of managing complex problems relating to reproductive endocrinology and infertility. PEACH STATE MEDICAL PRACTICE, PC NPI is 1801544093. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Kindbody Of Nc Medical Practice, Pc.

The provider's business location address is:

420 PROVIDENCE RD
CHARLOTTE, NC
ZIP 28207
Phone: (855) 563-2639

The provider's authorized official is Fahimeh Sasan .
The authorized official title is Founding Obgyn and has the following contact phone number (855) 563-2639.

The CLIA number assigned to this NPI record is 34D2312489 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/16/2022 and was last updated on 5/20/2024.

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
1207VE0102XObstetrics & GynecologyReproductive EndocrinologyYes
2207VG0400XObstetrics & GynecologyGynecologyNo

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: 11/21/2025

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