Provider Demographics
NPI:1699059725
Name:KUCHARSKI, MELISSA MARIE
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:MARIE
Last Name:KUCHARSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9805 SANDY ROCK PL STE H
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-7731
Mailing Address - Country:US
Mailing Address - Phone:980-245-2018
Mailing Address - Fax:980-245-2036
Practice Address - Street 1:9805 SANDY ROCK PL STE H
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-7731
Practice Address - Country:US
Practice Address - Phone:704-900-9589
Practice Address - Fax:704-377-9361
Is Sole Proprietor?:No
Enumeration Date:2011-10-07
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10-00234281744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management