MEDICARE: CHARLOTTE NEUROLOGY, 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	261QM2500X	Medical Specialty Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811135676
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHARLOTTE NEUROLOGY, PLLC

Provider Business Mailing Address
First Line	:	3041 SENNA DR
Second Line	:	SUITE B
City	:	MATTHEWS
State	:	NC
Zip	:	28105-6727
Country	:	US
Telephone Number	:	704-503-0015
Fax Number	:

Provider Business Practice Location Address
First Line	:	3041 SENNA DR
Second Line	:	SUITE B
City	:	MATTHEWS
State	:	NC
Zip	:	28105-6727
Country	:	US
Telephone Number	:	704-503-0015
Fax Number	:

Authorized Official
Title or Position	:	NEUROLOGIST
Name	:	DR. MUHAMMAD AKHTAR
Credential	:	MD
Telephone Number	:	704-503-0015

Provider Enumeration Date	:	01/30/2009
Last Update Date	:	01/30/2009

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