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General NPI Number Information
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NPI Number | 1114596723
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Entity Type | Individual
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Provider Name | MARIE ELIZABETH HUEGEL OD
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Gender | Female
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Dates
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Enumeration Date | 06/18/2021
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Last Update Date | 07/29/2022
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Provider Practice Location Address
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Address Line | 9651 BROOKDALE DR STE 800
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City | CHARLOTTE
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State | NC
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Zip | 28215-8105
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Country | US
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Telephone | 704-536-6042
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Fax |
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Provider Business Mailing Address
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Address Line | 14032 WOODY POINT RD
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City | CHARLOTTE
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State | NC
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Zip | 28278-6923
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Country | US
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Telephone | 412-715-9351
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2662
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3732
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License Number State | MN
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