Individual
DUSTIN M SOUTHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
920 CHURCH ST N, CONCORD, NC 28025-2927
(704) 403-1689
Mailing address
5025 AIRPORT CENTER PKWY BLDG L, CHARLOTTE, NC 28208-5885
(704) 512-7105
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
184216
NC
Other
Enumeration date
12/28/2013
Last updated
12/29/2017
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