Organization
SOUTH CHARLOTTE GENERAL AND VASCULAR SURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES NELSON ANTEZANA M.D. (GENERAL AND VASCULAR SURGEON)
(803) 412-5126
Entity
Organization
Contact information
Practice address
13430 HOOVER CREEK BLVD STE 200, CHARLOTTE, NC 28273-0054
(704) 910-8380
(704) 710-8045
Mailing address
13430 HOOVER CREEK BLVD STE 200, CHARLOTTE, NC 28273-0054
(704) 910-8380
(704) 710-8045
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2009-00158
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
59-13992
—
NC
Enumeration date
01/05/2011
Last updated
05/30/2023
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