Healthcare Provider Details

I. General information

NPI: 1649899436
Provider Name (Legal Business Name): THOMAS OFFERLE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2020
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8045 PROVIDENCE RD STE 300
CHARLOTTE NC
28277-8915
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:
  • Fax: 704-341-9996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number01648
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: