Organization
SOUTHPARK FUNCTIONAL MEDICINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARITA MAHTANI MD (PHYSICIAN)
(704) 560-3316
Entity
Organization
Contact information
Practice address
5950 FAIRVIEW RD STE 406, CHARLOTTE, NC 28210-3113
(704) 560-3316
Mailing address
5950 FAIRVIEW RD STE 406, CHARLOTTE, NC 28210-3113
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
05/10/2023
Last updated
08/02/2023
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