Healthcare Provider Details

I. General information

NPI: 1467365304
Provider Name (Legal Business Name): NC ORTHO SPINE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

10911 BLACK DOG LN STE D
CHARLOTTE NC
28214-1489
US

IV. Provider business mailing address

10911 BLACK DOG LN STE D
CHARLOTTE NC
28214-1489
US

V. Phone/Fax

Practice location:
  • Phone: 844-733-3774
  • Fax:
Mailing address:
  • Phone: 844-733-3774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ROSS SHERBAN
Title or Position: MANAGER
Credential: DO
Phone: 844-733-3774