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General NPI Number Information
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NPI Number | 1184728453
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Entity Type | Organization
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Legal Business Name | UNIVERSITY WOMENS CENTER PA
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Dates
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Enumeration Date | 09/08/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 8220 UNIVERSITY EXEC PARK DR STE 107
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City | CHARLOTTE
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State | NC
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Zip | 28262-3380
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Country | US
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Telephone | 704-548-1221
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Fax | 704-548-1311
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Provider Business Mailing Address
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Address Line | 8220 UNIVERSITY EXEC PARK DR STE 107
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City | CHARLOTTE
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State | NC
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Zip | 28262-3380
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Country | US
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Telephone | 704-548-1221
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Fax | 704-548-1311
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. ALEXANDER STEVEN PETOK
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Credential |
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Telephone | 704-548-1221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State | NC
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