Organization
ONCOLOGY SPECIALIST OF CHARLOTTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE JORDAN (EXECUTIVE DIRECTOR)
(704) 342-1900
Entity
Organization
Contact information
Practice address
2711 RANDOLPH RD STE 400, CHARLOTTE, NC 28207-2027
(704) 342-1900
(704) 377-0353
Mailing address
2711 RANDOLPH RD STE 400, SUITE 400, CHARLOTTE, NC 28207-2027
(704) 342-1900
(704) 377-0353
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02257
BCBSNC
NC
05
—
8902257
—
NC
01
—
CH1821
RR MEDICARE
—
Enumeration date
05/20/2006
Last updated
03/11/2026
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