Organization
THOMPSON CHILD AND FAMILY FOCUS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ELIZABETH PORRAS KANTROWITZ (ACCOUNTS RECEIVABLE)
(704) 536-0375
Entity
Organization
Contact information
Practice address
769 N WENDOVER RD, CHARLOTTE, NC 28211-1118
(704) 536-0375
(704) 531-9266
Mailing address
6800 SAINT PETERS LN, MATTHEWS, NC 28105-8458
(704) 536-0375
(704) 531-9266
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000
WAITING ON MEDICAID NUMBER
NC
Enumeration date
01/07/2009
Last updated
12/13/2017
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