Provider Demographics
NPI:1699946665
Name:STARMED HEALTHCARE, PLLC
Entity type:Organization
Organization Name:STARMED HEALTHCARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:STARR
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:980-229-1944
Mailing Address - Street 1:8008 PONDEROSA PINE LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-4540
Mailing Address - Country:US
Mailing Address - Phone:980-229-1944
Mailing Address - Fax:866-611-8122
Practice Address - Street 1:5100 REAGAN DR
Practice Address - Street 2:STE. #
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28206-3190
Practice Address - Country:US
Practice Address - Phone:704-494-8456
Practice Address - Fax:866-611-8122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201762363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6113034Medicaid