Individual
MS. SHAVONDA BAUMGARTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8401 MEDICAL PLAZA DR STE 250, CHARLOTTE, NC 28262
(704) 384-1500
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(844) 266-8268
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2015-01471
NC
207R00000X
Internal Medicine Physician
56231
TN
2083P0901X
Public Health & General Preventive Medicine Physician
56231
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56231
STATE OF TENNESSEE MEDICAL LICENSE
TN
Enumeration date
04/27/2012
Last updated
03/29/2023
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