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Organization
NC PREVENTATIVE MEDICINE AND WELLNESS CLINIC, PLLC
Active
Organization
NC PREVENTATIVE MEDICINE AND WELLNESS CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHRYN ANN SHAW M.D. (MEDICAL DIRECTOR/OWNER)
(704) 752-7779
Entity
Organization
Contact information
Practice address
7940 WILLIAMS POND LN, SUITE 150, CHARLOTTE, NC 28277-8766
(704) 752-7779
(704) 752-7775
Mailing address
7940 WILLIAMS POND LN, SUITE 150, CHARLOTTE, NC 28277-8766
(704) 752-7779
(704) 752-7775
Taxonomy
Speciality
Code
Description
License number
State
207QB0002X
Obesity Medicine (Family Medicine) Physician
Primary
—
NULL
207QB0002X
Obesity Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
08/20/2013
Last updated
08/20/2013
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