Healthcare Provider Details

I. General information

NPI: 1346391018
Provider Name (Legal Business Name): SPELIOS AND ASSOCIATES PA IV
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SPELIOS AND ASSOCIATES PA IV SUITE 120
CHARLOTTE NC
28210
US

IV. Provider business mailing address

5970 FAIRVIEW RD SUITE 120
CHARLOTTE NC
28210-3167
US

V. Phone/Fax

Practice location:
  • Phone: 704-552-1701
  • Fax: 704-552-1085
Mailing address:
  • Phone: 704-552-1701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM ANDREW LITTON
Title or Position: VICE PRESIDENT
Credential:
Phone: 678-879-1177