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General NPI Number Information
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NPI Number | 1396733820
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Entity Type | Individual
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Provider Name | BRITTANY BERGIN CLYNE MD
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Gender | Female
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Dates
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Enumeration Date | 10/10/2005
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Last Update Date | 09/18/2024
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Provider Practice Location Address
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Address Line | 1000 BLYTHE BLVD
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City | CHARLOTTE
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State | NC
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Zip | 28203-5812
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Country | US
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Telephone | 704-355-2372
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Fax | 704-355-6692
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Provider Business Mailing Address
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Address Line | 2208 HASTINGS DR
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City | CHARLOTTE
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State | NC
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Zip | 28207-2428
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Country | US
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Telephone | 704-726-1339
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 200300577
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License Number State | NC
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