Individual
PAUL C. WHITESIDES JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
75 EMERSON BAY RD, SUITE 102, CAROLINA SHORES, NC 28467-2498
(910) 579-8363
(910) 579-8306
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(910) 579-8363
(910) 579-8306
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
25968
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110065492
RAILROAD MEDICARE
NC
05
—
8987175
—
NC
Enumeration date
09/09/2005
Last updated
10/25/2020
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