Organization
NORTHCROSS MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK LE MD (SUPERVISOR/OWNER)
(704) 895-3415
Entity
Organization
Contact information
Practice address
16511 NORTHCROSS DR, SUITE A, HUNTERSVILLE, NC 28078-5021
(704) 895-3415
(704) 865-3416
Mailing address
16511 NORTHCROSS DR, SUITE A, HUNTERSVILLE, NC 28078-5021
(704) 895-3415
(704) 895-3416
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
102875 (PROVISIONAL)
NC
103TR0400X
Rehabilitation Psychologist
102875 (PROVISIONAL)
NC
Other
Enumeration date
04/05/2010
Last updated
04/05/2010
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