Healthcare Provider Details

I. General information

NPI: 1932189545
Provider Name (Legal Business Name): CAROLINA BONE & JOINT PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 05/17/2024
Certification Date: 05/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 E SUNSET DR
MONROE NC
28112-4324
US

IV. Provider business mailing address

10508 PARK RD STE 120
CHARLOTTE NC
28210-8526
US

V. Phone/Fax

Practice location:
  • Phone: 704-289-4595
  • Fax: 704-289-5829
Mailing address:
  • Phone: 704-541-3055
  • Fax: 704-319-2166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StateNC

VIII. Authorized Official

Name: NEAL MICHAEL GOLDBERGER
Title or Position: PARTNER/AUTHORIZED OFFICIAL
Credential: MD
Phone: 704-289-4595