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General NPI Number Information
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NPI Number | 1104113745
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Entity Type | Organization
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Legal Business Name | CHARLOTTE CARDIOLOGY ASSOCIATES, PLLC
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Dates
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Enumeration Date | 07/04/2011
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Last Update Date | 06/01/2015
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Provider Practice Location Address
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Address Line | 7666 CHARLOTTE HWY STE 230
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City | INDIAN LAND
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State | SC
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Zip | 29707
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Country | US
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Telephone | 803-547-8800
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Fax | 803-547-8822
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Provider Business Mailing Address
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Address Line | 7666 CHARLOTTE HWY STE 230
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City | INDIAN LAND
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State | SC
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Zip | 29707
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Country | US
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Telephone | 803-547-8800
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Fax | 803-547-8822
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Authorized Official
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Title or Position | BILLING
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Name | KELLY SINAGRA
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Credential |
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Telephone | 803-547-8800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 477
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License Number State | SC
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