Provider Demographics
NPI:1194719385
Name:CAMPBELL, MARGARET ELLEN FERRITER (MD)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:ELLEN FERRITER
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10202 HOLLYBROOK DR
Mailing Address - Street 2:HEALTH DIRECTION, INC.
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-0508
Mailing Address - Country:US
Mailing Address - Phone:704-622-4905
Mailing Address - Fax:
Practice Address - Street 1:601 GARDENBROOK TRL
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-6541
Practice Address - Country:US
Practice Address - Phone:704-622-4905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC27587207R00000X
NC39737208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC275874Medicaid
NC8912524Medicaid
SCGP2323Medicaid
NCNC2971CMedicare PIN
SCGP2323Medicaid
E64606Medicare UPIN
SCE64606Medicare ID - Type Unspecified
NC8912524Medicaid