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Organization

CENTER FO EMOTIONAL HEALTH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JONATHAN K STOUDMIRE M.D. (PRESIDENT/OWNER)
(704) 699-5296
Entity
Organization

Contact information

Practice address
280 EXECUTIVE PARK DR, SUITE 100, CONCORD, NC 28025-1837
(704) 785-8282
(704) 785-8304
Mailing address
280 EXECUTIVE PARK DR, SUITE 100, CONCORD, NC 28025-1837

Taxonomy

Speciality
Code
Description
License number
State
2084P0015X
Psychosomatic Medicine Physician
Primary
200500827
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5900927
NC
Enumeration date
08/13/2014
Last updated
08/13/2014
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