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General NPI Number Information
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NPI Number | 1396756722
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Entity Type | Individual
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Provider Name | PAUL COLAVITA
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Gender | Male
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 04/15/2019
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Provider Practice Location Address
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Address Line | 1001 BLYTHE BLVD SUITE 300 - ADULT CARDIOLOGY
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City | CHARLOTTE
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State | NC
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Zip | 28203-5866
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Country | US
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Telephone | 704-373-0212
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 BLYTHE BLVD SUITE 300 - ADULT CARDIOLOGY
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City | CHARLOTTE
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State | NC
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Zip | 28203-5866
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Country | US
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Telephone |
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 14437
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 26215
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License Number State | NC
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