Provider Demographics
NPI:1396707568
Name:MASON, HOWARD K (MD)
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:K
Last Name:MASON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6900 FARMINGDALE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28212-5551
Mailing Address - Country:US
Mailing Address - Phone:704-536-6853
Mailing Address - Fax:704-445-4582
Practice Address - Street 1:1201 S POST RD STE 100
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28152-7438
Practice Address - Country:US
Practice Address - Phone:704-481-7001
Practice Address - Fax:704-445-4582
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC302062084A0401X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ889602Medicaid
C82139Medicare UPIN
79631Medicare ID - Type Unspecified