Healthcare Provider Details

I. General information

NPI: 1003164096
Provider Name (Legal Business Name): SURGICAL SPECIALISTS OF CHARLOTTE-UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2012
Last Update Date: 02/08/2022
Certification Date: 02/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10320 MALLARD CREEK RD STE 100
CHARLOTTE NC
28262-5204
US

IV. Provider business mailing address

PO BOX 33369
CHARLOTTE NC
28233-3369
US

V. Phone/Fax

Practice location:
  • Phone: 704-547-9196
  • Fax: 704-414-6803
Mailing address:
  • Phone: 704-333-0741
  • Fax: 704-365-2073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LOUIS H ZBINDEN III
Title or Position: PRESIDENT
Credential: M.D.
Phone: 704-364-8100