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General NPI Number Information
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NPI Number | 1003022468
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Entity Type | Individual
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Provider Name | JENNIFER EGAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 1000 BLYTHE BLVD
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City | CHARLOTTE
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State | NC
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Zip | 28203-5812
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Country | US
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Telephone | 704-973-5500
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 96782
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City | CHARLOTTE
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State | NC
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Zip | 28296-6782
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Country | US
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Telephone | 704-973-5500
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number | 2007-00191
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License Number State | NC
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