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NPI Code Detail

MEDICARE: ADAIR BROADWAY

MEDICARE: ADAIR BROADWAY
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
1106E00000XAssistant Behavior AnalystNC
2103K00000XBehavior Analyst1-25-81080NC

General Provider Information

NPI Number : 1821849316
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADAIR BROADWAY
Provider Business Mailing Address
First Line : 7809 SARDIS RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28270-2757
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7809 SARDIS RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28270-2757
Country : US
Telephone Number : 980-833-1329
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2024
Last Update Date : 09/29/2025

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Directions to “ ADAIR BROADWAY ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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