Healthcare Provider Details

I. General information

NPI: 1659357309
Provider Name (Legal Business Name): MA CRISTINA MERERIA OCAMPO NC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MA CRISTINA LAVAPIE MERERIA MD

II. Dates (important events)

Enumeration Date: 12/15/2005
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 MATTHEWS TOWNSHIP PKWY STE 450
MATTHEWS NC
28105-5343
US

IV. Provider business mailing address

PO BOX 60447
CHARLOTTE NC
28260-0447
US

V. Phone/Fax

Practice location:
  • Phone: 704-384-8480
  • Fax: 704-384-8481
Mailing address:
  • Phone: 312-733-9730
  • Fax: 773-866-8014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number202103242
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: