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NPI Code Detail

MEDICARE: JODY SEPICH MD

MEDICARE: JODY SEPICH MD
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
1207R00000XInternal Medicine Physician2005-01202NC

General Provider Information

NPI Number : 1336193234
Entity Type Code : Individual
Provider Name (Legal Business Name) : JODY SEPICH MD
Provider Business Mailing Address
First Line : PO BOX 19305
Second Line :
City : CHARLOTTE
State : NC
Zip : 28219-9305
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1705 GARDNER DR
Second Line :
City : WILMINGTON
State : NC
Zip : 28405-8873
Country : US
Telephone Number : 910-343-5300
Fax Number : 910-254-1352
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2006
Last Update Date : 04/30/2020

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