Individual
JOHN MARVIN BETHUNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1530 PROVIDENCE RD S, WAXHAW, NC 28173-8313
(704) 627-8365
(704) 627-8366
Mailing address
PO BOX 601843, CHARLOTTE, NC 28260-1843
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5014484
NC
363L00000X
Nurse Practitioner
APN.23980APRN
SC
Other
Enumeration date
03/14/2020
Last updated
02/20/2023
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