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Individual

EMIL PETER OCCHIBOI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C, ATC

Contact information

Practice address
4741 RANDOLPH RD STE 100&200, CHARLOTTE, NC 28211-2919
(704) 365-6730
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
000907
CT
363A00000X
Physician Assistant
Primary
0010-08548
NC
363AS0400X
Surgical Physician Assistant
23.004688
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NN5848A
NC
Enumeration date
01/22/2015
Last updated
01/06/2025
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