Individual
MAKEDA TIYE YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
200 MEDICAL PARK DR STE 430, CONCORD, NC 28025-0939
(704) 403-7070
Mailing address
7348 OAKWOOD LN, CHARLOTTE, NC 28215-3622
(910) 977-0381
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
001014623
NC
Other
Enumeration date
11/18/2024
Last updated
11/21/2024
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