Individual
DR. ANDREW J KAPUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3623 LATROBE DR, STE 216, CHARLOTTE, NC 28211
(704) 332-1291
(704) 332-5206
Mailing address
PO BOX 221249, CHARLOTTE, NC 28222-1249
(704) 332-1291
(704) 332-5206
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
200500553
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5902121
—
NC
05
—
N53005
—
SC
Enumeration date
03/23/2006
Last updated
09/11/2020
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