Healthcare Provider Details
I. General information
NPI: 1174868368
Provider Name (Legal Business Name): DOCTORS PLUS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/29/2012
Last Update Date: 11/03/2022
Certification Date: 11/03/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
205 BRANCHVIEW DR NE
CONCORD NC
28025-3416
US
IV. Provider business mailing address
205 BRANCHVIEW DR NE
CONCORD NC
28025-3416
US
V. Phone/Fax
- Phone: 704-440-4689
- Fax: 704-956-2193
- Phone: 704-440-4689
- Fax: 704-956-2193
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207PE0004X |
| Taxonomy | Emergency Medical Services (Emergency Medicine) Physician |
| License Number | 2007-00071 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 2007-00071 |
| License Number State | NC |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 291U00000X |
| Taxonomy | Clinical Medical Laboratory |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0002X |
| Taxonomy | Clinic Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DENNIS
SEETAL
PERSAUD
Title or Position: OWNER
Credential: M.D.
Phone: 704-440-4689