Individual
MICHAEL PENNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
PO BOX 896244, CHARLOTTE, NC 28289-0001
(413) 329-4987
Mailing address
PO BOX 896244, CHARLOTTE, NC 28289-6244
(413) 329-4987
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2024-02338
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/27/2021
Last updated
10/16/2024
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