Healthcare Provider Details

I. General information

NPI: 1013093038
Provider Name (Legal Business Name): ASTHMA & ALLERGY SPECIALISTS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 04/10/2024
Certification Date: 04/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8045 PROVIDENCE RD STE 300
CHARLOTTE NC
28277
US

IV. Provider business mailing address

8045 PROVIDENCE RD STE 300
CHARLOTTE NC
28277-8915
US

V. Phone/Fax

Practice location:
  • Phone: 704-341-9600
  • Fax: 704-341-9996
Mailing address:
  • Phone: 704-341-9600
  • Fax: 704-341-9996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HEATHER HILL
Title or Position: PRACTICE MANAGER
Credential:
Phone: 704-341-9600