Individual
MR. CLINT DAVID PRICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
501 S SHARON AMITY RD STE 300, CHARLOTTE, NC 28211-0035
(704) 377-2424
Mailing address
501 S SHARON AMITY RD STE 300, CHARLOTTE, NC 28211-0035
(704) 377-2424
(704) 377-2687
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
102155
NC
363AM0700X
Medical Physician Assistant
Primary
102155
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053330480
—
NC
01
—
74568
NCBCBS
NC
05
—
8974568
—
NC
01
—
970022487
MEDICARE RAILROAD
NC
01
—
P00155278
RR MEDICARE
NC
Enumeration date
07/18/2006
Last updated
12/07/2023
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