Individual
FREDERICO JOSE REIS SOARES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1021 MOREHEAD MEDICAL DR, CHARLOTTE, NC 28204-2990
(980) 442-2000
Mailing address
105 W C ST, BECKLEY, WV 25801-5502
(570) 561-7901
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
5015542
NC
Other
Enumeration date
01/12/2022
Last updated
01/13/2022
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