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1053855296
DEREK MEDEIROS
CHARLOTTE, NC
NPI
1053855296
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
243U00000X Radiology Practitioner Assistant
(Licence: MA 15MA1496)
Enumeration Date
2016-12-07
Last Update Date
2016-12-07
Business Address
DEREK MEDEIROS R.T, R.R.A, R.P.A
6836 MORRISON BLVD STE 101
CHARLOTTE, NC 28211-2612
Phone number: 704-817-0821
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Mailing Address
DEREK MEDEIROS R.T, R.R.A, R.P.A
6836 MORRISON BLVD SUITE 101
CHARLOTTE, NC 28211-2612
Phone number: 704-817-0821
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