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General NPI Number Information
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NPI Number | 1982899035
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Entity Type | Organization
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Legal Business Name | CHARLOTTE EYE EAR NOSE & THROAT ASSOCIATES, PA
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Dates
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Enumeration Date | 09/12/2007
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Last Update Date | 09/12/2007
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Provider Practice Location Address
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Address Line | 1223 SPRUCE ST
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City | BELMONT
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State | NC
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Zip | 28012-3371
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Country | US
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Telephone | 704-295-3000
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Fax | 704-295-3468
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Provider Business Mailing Address
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Address Line | 6035 FAIRVIEW RD
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City | CHARLOTTE
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State | NC
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Zip | 28210-3256
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Country | US
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Telephone | 704-295-3000
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Fax | 704-295-3468
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Authorized Official
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Title or Position | STAFF MD
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Name | DR. ANDREW NICHOLAS ANTOSZYK
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Credential | MD
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Telephone | 704-295-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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