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Southpark Pediatrics, P.a.
Specialist in Charlotte, North Carolina
NPI 1710215256

Southpark Pediatrics, P.a. is a Specialist based in Charlotte, NC. Southpark Pediatrics, P.a. practices in Charlotte, NC. The NPI Number for Southpark Pediatrics, P.a. is 1710215256 and holds a License No. 9501464 (North Carolina).

The current practice location address for Southpark Pediatrics, P.a. is 4601 Park Rd, Charlotte, NC and can be reached out via phone at 704-522-6656 and via fax at 704-522-6665.

Location: 4601 Park Rd, Charlotte, NC, 28209-3239
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1710215256
Provider Name
Southpark Pediatrics, P.a.
Credential
Provider Entity Type
Organization
Address
4601 Park Rd, Charlotte, NC, 28209-3239
Phone Number
704-522-6656
Fax Number
704-522-6665
Provider Enumeration Date
11/20/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
89013J5 05 NC
institution
Provider Business Practice Location Address Details
Address
4601 Park Rd
City
Charlotte
State
North Carolina
Zip
28209-3239
Phone Number
704-522-6656
Fax Number
704-522-6665
person
Provider Business Mailing Address Details
Address
4601 Park Rd
City
Charlotte
State
North Carolina
Zip
28209-3239
Phone Number
704-522-6656
Fax Number
704-522-6665
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
9501464 (North Carolina)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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