Organization
SIGNATURE HEALTHCARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANNETTE K ANSELMO (EXECUTIVE DIRECTOR)
(704) 554-8787
Entity
Organization
Contact information
Practice address
6115 PARK SOUTH DR, SUITE 100, CHARLOTTE, NC 28210-3269
(704) 554-8787
(704) 554-8774
Mailing address
6115 PARK SOUTH DR, SUITE 100, CHARLOTTE, NC 28210-3269
(704) 554-8787
(704) 554-8774
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014HN
BCBS
NC
Enumeration date
06/03/2006
Last updated
09/21/2010
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