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Individual

DEREK MEDEIROS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
R.T, R.R.A, R.P.A

Contact information

Practice address
6836 MORRISON BLVD STE 101, CHARLOTTE, NC 28211-2612
(704) 817-0821
(704) 817-0835
Mailing address
6836 MORRISON BLVD, SUITE 101, CHARLOTTE, NC 28211-2612
(704) 817-0821
(704) 817-0835

Taxonomy

Speciality
Code
Description
License number
State
243U00000X
Radiology Practitioner Assistant
Primary
15MA1496
MA

Other

Enumeration date
12/07/2016
Last updated
12/07/2016
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