MEDICARE: KING TUT CHIROPRACTOR

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
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1376476671
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KING TUT CHIROPRACTOR

Provider Business Mailing Address
First Line	:	6303 CARMEL RD STE 101
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28226-8281
Country	:	US
Telephone Number	:	980-339-9571
Fax Number	:

Provider Business Practice Location Address
First Line	:	6303 CARMEL RD STE 101
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28226-8281
Country	:	US
Telephone Number	:	980-339-9571
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	AMGAD DEMETRY
Credential	:
Telephone Number	:	980-339-9571

Provider Enumeration Date	:	06/05/2026
Last Update Date	:	06/05/2026

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Directions to “KING TUT CHIROPRACTOR ” Practice Location

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