Healthcare Provider Details

I. General information

NPI: 1528029840
Provider Name (Legal Business Name): AMALIA SILVIA FALCON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 MEDICAL PLAZA DR SUITE 350
CHARLOTTE NC
28262-8797
US

IV. Provider business mailing address

1405 LACY LN
ROCK HILL SC
29732-7723
US

V. Phone/Fax

Practice location:
  • Phone: 704-547-0020
  • Fax: 704-594-9759
Mailing address:
  • Phone: 803-366-8585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number39261
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: