MEDICARE: AMBER THOMPSON PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	0010-06987	NC

General Provider Information

NPI Number	:	1235306234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER THOMPSON PA

Provider Business Mailing Address
First Line	:	6700 FAIRVIEW RD STE 320
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28210-3324
Country	:	US
Telephone Number	:	704-200-9805
Fax Number	:

Provider Business Practice Location Address
First Line	:	6700 FAIRVIEW RD STE 320
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28210-3324
Country	:	US
Telephone Number	:	704-200-9805
Fax Number	:	833-909-3961

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2008
Last Update Date	:	04/10/2023

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