Healthcare Provider Details

I. General information

NPI: 1386628923
Provider Name (Legal Business Name): CHARLTON N OWENSBY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 04/04/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

812 W INNES ST
SALISBURY NC
28144-4152
US

IV. Provider business mailing address

3700 MOORLAND DR
CHARLOTTE NC
28226-1119
US

V. Phone/Fax

Practice location:
  • Phone: 704-637-8040
  • Fax: 704-637-9980
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number29362
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number29362
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: