Healthcare Provider Details

I. General information

NPI: 1588603005
Provider Name (Legal Business Name): DANIEL ROSS BRIGGS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 05/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 PROVIDENCE RD SUITE 101
CHARLOTTE NC
28207-1437
US

IV. Provider business mailing address

200 PROVIDENCE RD SUITE 101
CHARLOTTE NC
28207-1468
US

V. Phone/Fax

Practice location:
  • Phone: 704-749-5800
  • Fax: 704-749-5819
Mailing address:
  • Phone: 704-749-5800
  • Fax: 704-626-3067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number200600546
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: