Provider Demographics
NPI:1194793745
Name:ESTHER, MARY SUSAN (MD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:SUSAN
Last Name:ESTHER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:6035 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-3256
Mailing Address - Country:US
Mailing Address - Phone:704-295-3000
Mailing Address - Fax:704-295-3468
Practice Address - Street 1:6035 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-3256
Practice Address - Country:US
Practice Address - Phone:704-295-3000
Practice Address - Fax:704-295-3468
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC96001602084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC269145OtherWELLPATH
NCE0574OtherMEDCOST
NCP00202361OtherRAILROAD MEDICARE
SC81894OtherCHC CARES OF SC
SC20097007OtherSELECT HEALTH OF SC
SCN00160Medicaid
NC30774OtherBCBS
NC4469887OtherAETNA
SC771257OtherWELLCARE
NC8930774Medicaid
SC000000291357OtherUNISON HEALTH PLAN OF SC
NCP00202361OtherRAILROAD MEDICARE
NC2228655AMedicare PIN