Healthcare Provider Details

I. General information

NPI: 1326931908
Provider Name (Legal Business Name): NATALIE OGUICH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2025
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 S SHARON AMITY RD
CHARLOTTE NC
28211-2896
US

IV. Provider business mailing address

PO BOX 601504
CHARLOTTE NC
28260-1504
US

V. Phone/Fax

Practice location:
  • Phone: 833-492-1675
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: