Individual
DR. WALID RAOUF ELTARABOULSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10320 FELD FARM LN STE 300, CHARLOTTE, NC 28210-8484
(980) 488-9870
(980) 488-9875
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
86883
SC
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
2011-01032
NC
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
86883
SC
207RP1001X
Pulmonary Disease Physician
Primary
2011-01032
NC
207RP1001X
Pulmonary Disease Physician
207RP1001X
NC
207RP1001X
Pulmonary Disease Physician
86883
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245491083
—
NC
01
—
2011-01032
NC LICENSE
NC
05
—
NC2170
—
SC
Enumeration date
06/24/2008
Last updated
10/29/2024
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