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General NPI Number Information
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NPI Number | 1215995444
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Entity Type | Organization
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Legal Business Name | CAROLINA ASTHMA AND ALLERGY CENTER PA
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 09/12/2014
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Provider Practice Location Address
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Address Line | 2630 E 7TH ST SUITE 100
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City | CHARLOTTE
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State | NC
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Zip | 28204-4319
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Country | US
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Telephone | 704-372-7900
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Fax | 704-376-2216
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Provider Business Mailing Address
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Address Line | PO BOX 63376
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City | CHARLOTTE
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State | NC
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Zip | 28263-3376
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Country | US
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Telephone | 704-372-7900
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Fax | 704-376-2216
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN GRAY NORRIS
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Credential | MD
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Telephone | 704-372-7900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 00-18118
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License Number State | NC
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