Organization
MID-CHARLOTTE DERMATOLOGY AND RESEARCH PLLC
Active
Other names
Southeast Vulvar Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IRENE ELIZABETH EDWARDS MD (OWNER)
(704) 367-9777
Entity
Organization
Contact information
Practice address
6406 CARMEL RD STE 309, CHARLOTTE, NC 28226-8267
(704) 367-9777
(704) 367-0504
Mailing address
6406 CARMEL RD STE 309, CHARLOTTE, NC 28226-8267
(704) 367-9777
(704) 367-0504
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
23521
NC
207R00000X
Internal Medicine Physician
23521
NC
208000000X
Pediatrics Physician
23521
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5922883
—
NC
Enumeration date
09/07/2007
Last updated
03/01/2022
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