# CHARLOTTE GASTROENTEROLOGY & HEPATOLOGY, PLLC

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

## Provider details

- **NPI number:** 1619124401
- **Authorized official:** MRS. JENNIFER HICKS (CHIEF EXECUTIVE OFFI)
- **Authorized official phone:** (704) 377-4009

## Contact information

- **Practice address:** 11430 RED RUST LN STE 101, CHARLOTTE, NC 28277-4948
- **Practice address phone:** (704) 377-4009
- **Mailing address:** 13808 PROFESSIONAL CENTER DR, HUNTERSVILLE, NC 28078-7948
- **Mailing address phone:** (704) 377-4009
- **Mailing address fax:** (704) 375-6970

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/22/2008
- **Last updated:** 02/24/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3409963 | — | NC |