Organization
CHARLOTTE SPORTS MEDICINE INSTITUTE, P.A.
Active
Organization
CHARLOTTE SPORTS MEDICINE INSTITUTE, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN J. PAUL M.D. (OWNER)
(704) 509-6427
Entity
Organization
Contact information
Practice address
10616 METROMONT PKWY, SUITE 106, CHARLOTTE, NC 28269-7656
(704) 509-6427
(704) 509-6964
Mailing address
10616 METROMONT PKWY, SUITE 106, CHARLOTTE, NC 28269-7656
(704) 509-6427
(704) 509-6964
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
009700704
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1051M
BCBS
NC
05
—
891051M
—
NC
Enumeration date
03/31/2009
Last updated
12/08/2014
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