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NPI Code Detail

MEDICARE: CHARLES MAURICE PHIFER

MEDICARE: CHARLES MAURICE PHIFER
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
1224Z00000XOccupational Therapy Assistant8342NC

General Provider Information

NPI Number : 1679828719
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES MAURICE PHIFER
Provider Business Mailing Address
First Line : PO BOX 480777
Second Line :
City : CHARLOTTE
State : NC
Zip : 28269-5306
Country : US
Telephone Number : 704-965-5377
Fax Number :
Provider Business Practice Location Address
First Line : 620 TOM HUNTER RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28213-5511
Country : US
Telephone Number : 704-900-5513
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2012
Last Update Date : 07/15/2012

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Directions to “ CHARLES MAURICE PHIFER ” Practice Location

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