Healthcare Provider Details

I. General information

NPI: 1295723062
Provider Name (Legal Business Name): CHARLES WINSTON W. RHODES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 MOORESVILLE RD
KANNAPOLIS NC
28081-0304
US

IV. Provider business mailing address

300 MOORESVILLE RD
KANNAPOLIS NC
28081-0304
US

V. Phone/Fax

Practice location:
  • Phone: 704-920-1000
  • Fax: 704-934-4270
Mailing address:
  • Phone: 704-920-1000
  • Fax: 704-934-4270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25411
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: