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1922031319
JOSE PLAZA
CHARLOTTE, NC
NPI
1922031319
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207P00000X Emergency Medicine
(Licence: NC 9700713)
Enumeration Date
2006-07-08
Last Update Date
2013-01-16
Business Address
-- JOSE PLAZA MD
3128 WILLOW OAK RD
CHARLOTTE, NC 28209-1518
Phone number: 704-577-5050
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Mailing Address
-- JOSE PLAZA MD
3128 WILLOW OAK RD
CHARLOTTE, NC 28209-1518
Phone number: 704-577-5050
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