Individual
PRESTON PEMBERTON PURDUM III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
300 BILLINGSLEY RD STE 200, CHARLOTTE, NC 28211-1084
(704) 372-7974
(704) 372-5166
Mailing address
11301 CARMEL COMMONS BLVD, STE 302, CHARLOTTE, NC 28226-5305
(704) 372-7974
(704) 372-8201
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
9500190
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8969467
—
NC
Enumeration date
07/10/2006
Last updated
05/04/2017
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