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NPI Code Detail

MEDICARE: MRS. DIANNE PATRICIA SARLES

MEDICARE:  MRS. DIANNE PATRICIA SARLES
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
1174400000XSpecialistA4440NC

General Provider Information

NPI Number : 1871861419
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DIANNE PATRICIA SARLES
Provider Business Mailing Address
First Line : 4109 MEDOC MOUNTAIN DR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28270-1627
Country : US
Telephone Number : 704-321-9791
Fax Number :
Provider Business Practice Location Address
First Line : 4109 MEDOC MOUNTAIN DR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28270-1627
Country : US
Telephone Number : 704-321-9791
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2011
Last Update Date : 12/11/2011

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Directions to “ MRS. DIANNE PATRICIA SARLES ” Practice Location

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