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General NPI Number Information
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NPI Number | 1437301116
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Entity Type | Organization
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Legal Business Name | NORTH CHARLOTTE PLASTIC & RECONSTRUCTIVE SURGERY, P.A.
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Dates
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Enumeration Date | 10/14/2008
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Last Update Date | 04/28/2014
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Provider Practice Location Address
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Address Line | 9735 KINCEY AVE STE 104
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-9118
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Country | US
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Telephone | 704-896-5556
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Fax | 704-896-5585
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Provider Business Mailing Address
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Address Line | 9735 KINCEY AVE STE 104
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-9118
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Country | US
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Telephone | 704-896-5556
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Fax | 704-896-5585
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ERIK JOHN MILES
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Credential | M.D.
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Telephone | 704-896-5556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 2007-00556
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License Number State | NC
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