Individual
SHELEY RENE' REVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8401 MEDICAL PLAZA DR, SUITE 250, CHARLOTTE, NC 28262-8797
(704) 384-1500
(704) 384-1525
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-1500
(704) 384-1525
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9500197
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8971329
—
NC
Enumeration date
07/06/2006
Last updated
06/26/2023
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