Individual
DR. PHILIP A VISSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1350 S KINGS DR, CHARLOTTE, NC 28207-2134
(704) 446-1255
(704) 446-1276
Mailing address
PO BOX 601372, CHARLOTTE, NC 28260-1372
(704) 446-1255
(704) 446-1276
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
27643
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457383135
—
NC
01
—
85096
NCBCBS
NC
05
—
8985096
—
NC
05
—
N27643
—
SC
Enumeration date
07/06/2006
Last updated
10/02/2014
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