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Individual

ELIZABETH BUMGARNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
14214 BALLANTYNE LAKE RD, SUITE 300, CHARLOTTE, NC 28277-3372
(704) 667-2600
Mailing address
14214 BALLANTYNE LAKE RD, CHARLOTTE, NC 28277-3372

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2010-01070
NC

Other

Enumeration date
08/26/2005
Last updated
02/12/2019
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