Provider Demographics
NPI:1871781781
Name:NORTH CHARLOTTE PLASTIC SURGERY
Entity type:Organization
Organization Name:NORTH CHARLOTTE PLASTIC SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:HARDMAN
Authorized Official - Last Name:HARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-840-9151
Mailing Address - Street 1:7306 SWANSEA LN
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-8696
Mailing Address - Country:US
Mailing Address - Phone:704-840-9151
Mailing Address - Fax:
Practice Address - Street 1:13620 REESE BLVD EAST BLDG XII
Practice Address - Street 2:SUITE 110
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078
Practice Address - Country:US
Practice Address - Phone:704-840-9151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-05
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty