Healthcare Provider Details

I. General information

NPI: 1861899338
Provider Name (Legal Business Name): HEARING AND BALANCE SOLUTIONS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2014
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 COLONY RD STE B
CHARLOTTE NC
28211-5022
US

IV. Provider business mailing address

3900 COLONY RD STE B
CHARLOTTE NC
28211-5022
US

V. Phone/Fax

Practice location:
  • Phone: 704-944-4283
  • Fax: 980-819-7817
Mailing address:
  • Phone: 704-944-4283
  • Fax: 980-819-7817

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number11105
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number11105
License Number StateNC

VIII. Authorized Official

Name: DR. GOUTHAM KRISHNA GOSU
Title or Position: OWNER/AUDIOLOGIST
Credential: AU.D,FAAA
Phone: 267-243-5321