Individual
PATRICK RYAN FILLNOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7903 PROVIDENCE RD STE 100, CHARLOTTE, NC 28277
(704) 316-1652
(704) 316-1653
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(844) 266-8268
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2011-01158
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538321120
—
NC
05
—
5918183
—
NC
05
—
NC1448
—
SC
Enumeration date
06/25/2008
Last updated
10/28/2020
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