Individual
GAETAN BANAWOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9841 NORTHLAKE CENTRE PKWY, CHARLOTTE, NC 28216-8930
(704) 598-2468
Mailing address
226 E 9TH ST UNIT 615, CHARLOTTE, NC 28202-3543
(434) 996-6124
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2415
SC
152W00000X
Optometrist
Primary
2775
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2775
OPTOMETRY LICENSE
NC
Enumeration date
06/14/2023
Last updated
04/09/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us