# ORTHOCAROLINA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588849327
- **Authorized official:** MS. ANGELA L MCLEMORE (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (704) 323-2081

## Contact information

- **Practice address:** 4601 PARK RD, SUITE 300, CHARLOTTE, NC 28209-3239
- **Practice address phone:** (704) 323-2081
- **Practice address fax:** (704) 323-3911
- **Mailing address:** 4601 PARK RD, SUITE 300, CHARLOTTE, NC 28209-3239
- **Mailing address phone:** (704) 323-2081
- **Mailing address fax:** (704) 323-3911

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AS0400X | Surgical Physician Assistant | — | NC | Yes |

## Other

- **Enumeration date:** 12/28/2007
- **Last updated:** 12/28/2007