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Organization
GENESIS ENT & PLASTIC SURGERY, PLLC
Active
Organization
GENESIS ENT & PLASTIC SURGERY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY FORD (ADMINISTRATOR)
(704) 544-1300
Entity
Organization
Contact information
Practice address
14835 JOHN J DELANEY DR, SUITE 210, CHARLOTTE, NC 28277-2738
(704) 544-1300
(704) 544-2765
Mailing address
14835 JOHN J DELANEY DR, SUITE 210, CHARLOTTE, NC 28277-2738
(704) 544-1300
(704) 544-2765
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
9700531
NC
Other
Enumeration date
06/11/2006
Last updated
08/22/2020
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