Provider Demographics
NPI:1285237131
Name:BEY, SERMETUT E
Entity type:Individual
Prefix:
First Name:SERMETUT
Middle Name:E
Last Name:BEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 QUEENS RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207-1860
Mailing Address - Country:US
Mailing Address - Phone:704-577-9028
Mailing Address - Fax:704-343-0275
Practice Address - Street 1:1000 QUEENS RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-1860
Practice Address - Country:US
Practice Address - Phone:704-577-9028
Practice Address - Fax:704-343-0275
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center