Individual
NINA LIVIA SHANDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2001 VAIL AVE, CHARLOTTE, NC 28207-1248
(704) 304-5000
Mailing address
1125 MORAY CT, CHARLOTTE, NC 28211-4300
(201) 321-9624
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2023-01360
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/23/2020
Last updated
06/21/2023
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