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Individual

JUSTIN BILANCIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
1350 S KINGS DR, CHARLOTTE, NC 28207-2134
(704) 446-4490
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-05245
NC
363A00000X
Physician Assistant
Primary
2026008856
MO
363A00000X
Physician Assistant
MA063564
PA
363A00000X
Physician Assistant
PA9361
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
104054970-0004
PA
Enumeration date
07/17/2006
Last updated
04/02/2026
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