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Organization

CHARLOTTE PEDIATRIC CLINIC

Active
Parent organization
CHARLOTTE PEDIATRIC CLINIC
Other names
Charlotte Pediatric Clinic, Atrium Health Levine Children's Charlotte Pediatrics
Organization subpart
Yes

Provider details

NPI number
Legal business name
CHARLOTTE PEDIATRIC CLINIC
Authorized official
SCOTT RISSMILLER (ENTERPRISE EVP)
(704) 355-8675
Entity
Organization

Contact information

Practice address
4501 CAMERON VALLEY PKWY, STE 100, CHARLOTTE, NC 28211-4297
(704) 367-7400
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
(704) 631-0002

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Enumeration date
11/03/2009
Last updated
03/09/2023
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