Provider Demographics
NPI:1992720932
Name:CHILDREN'S UROLOGY OF THE CAROLINAS
Entity type:Organization
Organization Name:CHILDREN'S UROLOGY OF THE CAROLINAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MEREDITH
Authorized Official - Middle Name:G
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-376-5636
Mailing Address - Street 1:230 BALDWIN AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-3110
Mailing Address - Country:US
Mailing Address - Phone:704-376-5636
Mailing Address - Fax:704-376-5933
Practice Address - Street 1:230 BALDWIN AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-3110
Practice Address - Country:US
Practice Address - Phone:704-376-5636
Practice Address - Fax:704-376-5636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC38823174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCG00867Medicare UPIN