MEDICARE: CAROLINA NEUROPATHY CENTERS, PLLC

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	207P00000X	Emergency Medicine Physician
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1770114555
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROLINA NEUROPATHY CENTERS, PLLC

Provider Business Mailing Address
First Line	:	19905 CATAMARAN CT
Second Line	:
City	:	CORNELIUS
State	:	NC
Zip	:	28031-6401
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4600 PARK RD STE 380
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28209-3666
Country	:	US
Telephone Number	:	704-236-8245
Fax Number	:

Authorized Official
Title or Position	:	OWNER, AUTHORIZED OFFICIAL
Name	:	ERIC CCHANDLEY
Credential	:
Telephone Number	:	704-236-8245

Provider Enumeration Date	:	01/30/2020
Last Update Date	:	10/28/2021

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