Individual
ANDREW ROBERT SHULSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6010 CARNEGIE BLVD, CHARLOTTE, NC 28209-4637
(704) 384-9966
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
9900679
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1232J
NCBCBS
NC
05
—
891232J
—
NC
05
—
N0067D
—
SC
Enumeration date
07/28/2006
Last updated
10/25/2020
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