Organization
ADVANTAGE VISION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAULA RENEE NEWSOME OD (CEO)
(704) 375-3935
Entity
Organization
Contact information
Practice address
1016 S CHURCH ST, CHARLOTTE, NC 28203-4002
(704) 375-3935
(704) 333-7238
Mailing address
1016 S CHURCH ST, CHARLOTTE, NC 28203-4002
(704) 375-3935
(704) 333-7238
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1087
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0203Q
BLUE CROSS BLUE SHIELD
NC
01
—
108363
WELLPATH
NC
01
—
295758
MEDCOST
NC
01
—
4418381
AETNA
NC
01
—
6382063
CIGNA
NC
05
—
8909651
—
NC
Enumeration date
10/20/2006
Last updated
09/20/2007
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