Healthcare Provider Details

I. General information

NPI: 1528249257
Provider Name (Legal Business Name): MARTA MARIA KALINSKI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2007
Last Update Date: 05/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2608 E 7TH ST
CHARLOTTE NC
28204
US

IV. Provider business mailing address

2608 E 7TH ST
CHARLOTTE NC
28204-4375
US

V. Phone/Fax

Practice location:
  • Phone: 704-355-9484
  • Fax:
Mailing address:
  • Phone: 704-355-9484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number93-00173
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207RB0002X
TaxonomyObesity Medicine (Internal Medicine) Physician
License Number9300173
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number9300173
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: