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General NPI Number Information
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NPI Number | 1467712778
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Entity Type | Organization
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Legal Business Name | CAROLINA ATTENTION SPECIALISTS - CHARLOTTE
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Dates
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Enumeration Date | 05/21/2012
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Last Update Date | 11/18/2015
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Provider Practice Location Address
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Address Line | 309 S SHARON AMITY RD SUITE 204
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City | CHARLOTTE
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State | NC
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Zip | 28211-2978
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Country | US
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Telephone | 704-319-0215
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Fax | 980-636-6518
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Provider Business Mailing Address
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Address Line | 309 S SHARON AMITY RD SUITE 204
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City | CHARLOTTE
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State | NC
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Zip | 28211-2978
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Country | US
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Telephone | 704-319-0215
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Fax | 980-636-6518
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHARLES THOMAS HUMPHRIES
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Credential | MD
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Telephone | 980-636-6502
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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