Organization
NORTH MECKLENBURG PLASTIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERI NOWICKY (VICE PRESIDENT)
(704) 947-8877
Entity
Organization
Contact information
Practice address
403 GILEAD RD, SUITE B, HUNTERSVILLE, NC 28078-6813
(704) 947-8877
Mailing address
13729 BRAMBOROUGH RD, HUNTERSVILLE, NC 28078-3719
(704) 947-8877
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
200201133
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1317V
BLUE CROSS
NC
01
—
5525536
AETNA
NC
Enumeration date
06/01/2007
Last updated
07/24/2008
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