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General NPI Number Information
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NPI Number | 1871781781
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Entity Type | Organization
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Legal Business Name | NORTH CHARLOTTE PLASTIC SURGERY
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Dates
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Enumeration Date | 10/05/2007
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Last Update Date | 10/05/2007
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Provider Practice Location Address
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Address Line | 13620 REESE BLVD EAST BLDG XII SUITE 110
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City | HUNTERSVILLE
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State | NC
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Zip | 28078
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Country | US
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Telephone | 704-840-9151
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Fax |
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Provider Business Mailing Address
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Address Line | 7306 SWANSEA LN
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City | CORNELIUS
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State | NC
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Zip | 28031-8696
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Country | US
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Telephone | 704-840-9151
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID HARDMAN HARLEY
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Credential | MD
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Telephone | 704-840-9151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | NC
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