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NPI Code Detail

MEDICARE: KATHERINE M STARACE P.A.-C.

MEDICARE:   KATHERINE M STARACE  P.A.-C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant1324SC
2363A00000XPhysician Assistant0010-04092NC

General Provider Information

NPI Number : 1205067428
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE M STARACE P.A.-C.
Provider Business Mailing Address
First Line : 9915 PARK CEDAR DR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-8905
Country : US
Telephone Number : 704-544-3263
Fax Number :
Provider Business Practice Location Address
First Line : 9915 PARK CEDAR DR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-8905
Country : US
Telephone Number : 866-389-2727
Fax Number : 401-652-9787
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2009
Last Update Date : 10/26/2020

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Directions to “ KATHERINE M STARACE P.A.-C.” Practice Location

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