Healthcare Provider Details

I. General information

NPI: 1457594871
Provider Name (Legal Business Name): THE PRESBYTERIAN HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2009
Last Update Date: 08/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 ABBEY PL
CHARLOTTE NC
28209-3733
US

IV. Provider business mailing address

1701 ABBEY PL
CHARLOTTE NC
28209-3733
US

V. Phone/Fax

Practice location:
  • Phone: 704-384-1800
  • Fax: 704-384-1830
Mailing address:
  • Phone: 704-384-1800
  • Fax: 704-384-1830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. DERRICK MARK BILLINGS
Title or Position: PRESIDENT
Credential:
Phone: 704-384-9113