Healthcare Provider Details

I. General information

NPI: 1558310078
Provider Name (Legal Business Name): DANIEL T. BIONDI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 W 10TH ST
CHARLOTTE NC
28202-2229
US

IV. Provider business mailing address

650 S TRYON ST # 440
CHARLOTTE NC
28202-3271
US

V. Phone/Fax

Practice location:
  • Phone: 704-626-3994
  • Fax: 704-585-8039
Mailing address:
  • Phone: 704-900-4152
  • Fax: 704-585-8039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2006-01409
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: