Individual
AMY POTEAT FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
656 CARPENTER AVE, MOORESVILLE, NC 28115-2538
(704) 664-5133
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(844) 266-8268
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
31812
NC
2080A0000X
Pediatric Adolescent Medicine Physician
31812
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8931621
—
NC
Enumeration date
12/02/2005
Last updated
10/25/2020
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