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NPI Code Detail

MEDICARE: ILONA SPITSYNA HUMES MD

MEDICARE: ILONA SPITSYNA HUMES 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
12084N0600XClinical Neurophysiology Physician2007-00322NC
22084N0400XNeurology Physician2007-00322NC

General Provider Information

NPI Number : 1386658383
Entity Type Code : Individual
Provider Name (Legal Business Name) : ILONA SPITSYNA HUMES 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 : 315 MEDICAL PARK DR
Second Line : STE 202
City : CONCORD
State : NC
Zip : 28025-1902
Country : US
Telephone Number : 704-403-1911
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2006
Last Update Date : 07/15/2024

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Directions to “ ILONA SPITSYNA HUMES MD” Practice Location

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