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Organization

STARKS PEDIATRICS AT MALLARD CREEK, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LAWANNA MARIE STARKS M.D. (OWNER)
(704) 717-2826
Entity
Organization

Contact information

Practice address
2315 W. ARBORS DRIVE, SUITE 115, CHARLOTTE, NC 28262-2639
(704) 717-2826
(704) 971-5014
Mailing address
2315 W. ARBORS DRIVE, SUITE 115, CHARLOTTE, NC 28262-2639
(704) 717-2826
(704) 971-5014

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2006-00525
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5906849
NC
Enumeration date
05/09/2007
Last updated
02/25/2010
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