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General NPI Number Information
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NPI Number | 1104010156
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Entity Type | Organization
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Legal Business Name | CUPID FAMILY PRACTICE PA
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Dates
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Enumeration Date | 09/04/2007
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Last Update Date | 02/05/2015
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Provider Practice Location Address
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Address Line | 2325 W. ARBORS DR. SUITE 102
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City | CHARLOTTE
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State | NC
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Zip | 28262-2559
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Country | US
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Telephone | 704-971-4445
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Fax | 704-971-4450
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Provider Business Mailing Address
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Address Line | 2325 W. ARBORS DR. SUITE 102
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City | CHARLOTTE
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State | NC
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Zip | 28262-2559
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Country | US
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Telephone | 704-971-4445
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Fax | 704-971-4450
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Authorized Official
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Title or Position | CEO
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Name | DR. MELISSA JO-ANN CUPID
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Credential | MD
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Telephone | 704-971-4445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 200301427
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 21652
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 200301427
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License Number State | NC
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