Individual
GLENCORA KHEIREDDINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6060 PIEDMONT ROW DR S FL 7, CHARLOTTE, NC 28287
(704) 489-3094
Mailing address
5950 FAIRVIEW RD STE 330, CHARLOTTE, NC 28210-2108
(704) 495-6334
(704) 817-7219
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
134019
NC
207R00000X
Internal Medicine Physician
Primary
2009-00399
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5913167
—
NC
05
—
N0039D
—
SC
Enumeration date
03/05/2007
Last updated
09/27/2018
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