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Individual

MARIA ALEJANDRA FAULK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
9820 CALLABRIDGE CT, CHARLOTTE, NC 28216-7669
(704) 394-3886
(704) 392-3699
Mailing address
307 ETHAN LN, BELMONT, NC 28012-4116
(919) 749-9891

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2255
NC
152W00000X
Optometrist
OEG002471
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5920812
NC
Enumeration date
10/27/2011
Last updated
05/20/2014
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