Individual
DR. TIA RENE' KONZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1900 RANDOLPH RD, CHARLOTTE, NC 28207-1122
(704) 384-1246
(704) 384-6072
Mailing address
1900 RANDOLPH RD, CHARLOTTE, NC 28207-1122
(704) 384-1246
(704) 384-6072
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
2009-01442
NC
2084P0800X
Psychiatry Physician
5101016063
MI
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
2009-01442
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5912201
—
NC
Enumeration date
02/26/2007
Last updated
11/24/2015
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