Healthcare Provider Details

I. General information

NPI: 1689799082
Provider Name (Legal Business Name): NEAL S TAUB, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 RANDOLPH RD SUITE 208
CHARLOTTE NC
28211-1032
US

IV. Provider business mailing address

3535 RANDOLPH RD SUITE 208
CHARLOTTE NC
28211-1032
US

V. Phone/Fax

Practice location:
  • Phone: 704-442-9805
  • Fax: 704-405-0868
Mailing address:
  • Phone: 704-442-9805
  • Fax: 704-405-0868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number35767
License Number StateNC

VIII. Authorized Official

Name: DR. NEAL S TAUB
Title or Position: PRESIDENT
Credential: M.D.
Phone: 704-442-9805