Healthcare Provider Details

I. General information

NPI: 1396707568
Provider Name (Legal Business Name): HOWARD K MASON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 07/01/2020
Certification Date: 07/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 S POST RD STE 100
SHELBY NC
28152-7438
US

IV. Provider business mailing address

6900 FARMINGDALE DR
CHARLOTTE NC
28212-5551
US

V. Phone/Fax

Practice location:
  • Phone: 704-481-7001
  • Fax: 704-445-4582
Mailing address:
  • Phone: 704-536-6853
  • Fax: 704-445-4582

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number30206
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number30206
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: