MEDICARE: MR. ELIE OSTA 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
1	207R00000X	Internal Medicine Physician	9501040	NC

General Provider Information

NPI Number	:	1861468902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ELIE OSTA MD

Provider Business Mailing Address
First Line	:	1916 SARDIS RD N STE 4
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28270-2614
Country	:	US
Telephone Number	:	704-755-5619
Fax Number	:	877-966-5905

Provider Business Practice Location Address
First Line	:	1916 SARDIS RD N STE 4
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28270-2614
Country	:	US
Telephone Number	:	704-755-5619
Fax Number	:	877-966-5905

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2006
Last Update Date	:	02/20/2026

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