Individual
SPORA MBOE ESUNJU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1420 E FRANKLIN ST, MONROE, NC 28112-5160
(704) 289-8427
(704) 283-5522
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
2021-02456
NC
207R00000X
Internal Medicine Physician
Primary
2021-02456
NC
207RG0100X
Gastroenterology Physician
2021-02456
NC
Other
Enumeration date
05/30/2018
Last updated
03/03/2025
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