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General NPI Number Information
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NPI Number | 1366567604
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Entity Type | Individual
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Provider Name | NUPUR PARESH MUTHA PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 09/07/2012
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Provider Practice Location Address
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Address Line | 210 EAST TRADE ST. E-186
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City | CHARLOTTE
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State | NC
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Zip | 28202
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Country | US
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Telephone | 704-971-1254
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Fax | 704-971-7537
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Provider Business Mailing Address
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Address Line | 10923 WILKLEE DR
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City | CHARLOTTE
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State | NC
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Zip | 28277
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Country | US
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Telephone | 919-225-5675
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH021929
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 22179
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License Number State | NC
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