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NPI Code Detail

MEDICARE: CATHERINE ELIZABETH POLITO PANICK MD

MEDICARE: CATHERINE ELIZABETH POLITO PANICK MD
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
12085R0202XDiagnostic Radiology Physician2024-01516NC

General Provider Information

NPI Number : 1760986178
Entity Type Code : Individual
Provider Name (Legal Business Name) : CATHERINE ELIZABETH POLITO PANICK MD
Provider Business Mailing Address
First Line : PO BOX 221249
Second Line :
City : CHARLOTTE
State : NC
Zip : 28222-1249
Country : US
Telephone Number : 704-332-1291
Fax Number :
Provider Business Practice Location Address
First Line : 3623 LATROBE DR STE 216
Second Line :
City : CHARLOTTE
State : NC
Zip : 28211-2117
Country : US
Telephone Number : 704-332-1291
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2018
Last Update Date : 04/20/2026

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