Healthcare Provider Details

I. General information

NPI: 1902408032
Provider Name (Legal Business Name): REPRODUCTIVE SPECIALISTS OF THE CAROLINAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2020
Last Update Date: 11/13/2020
Certification Date: 11/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1918 RANDOLPH RD STE 210
CHARLOTTE NC
28207-1109
US

IV. Provider business mailing address

1918 RANDOLPH RD STE 210
CHARLOTTE NC
28207-1109
US

V. Phone/Fax

Practice location:
  • Phone: 704-247-2209
  • Fax: 704-247-2210
Mailing address:
  • Phone: 704-247-2209
  • Fax: 704-247-2210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. DOROTHY PINKERTON
Title or Position: OFFICE MANAGER
Credential:
Phone: 704-247-2211