MEDICARE: SUPERIOR HEALTH MEDICAL, PLLC

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1407595085
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUPERIOR HEALTH MEDICAL, PLLC

Provider Business Mailing Address
First Line	:	8022 PROVIDENCE RD UNIT 500-165
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-9719
Country	:	US
Telephone Number	:	980-322-9742
Fax Number	:

Provider Business Practice Location Address
First Line	:	8322 PINEVILLE MATTHEWS RD STE 602
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28226-4823
Country	:	US
Telephone Number	:	704-389-9040
Fax Number	:	704-396-8388

Authorized Official
Title or Position	:	CEO/MANAGER
Name	:	DR. LISETTE MARIA AKERS
Credential	:	MD
Telephone Number	:	980-322-9742

Provider Enumeration Date	:	06/01/2022
Last Update Date	:	06/01/2022

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