Individual
MRS. VICTORIA BOUHAIRIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
15825 BALLANTYNE MEDICAL PL STE 220, CHARLOTTE, NC 28277-4790
(704) 316-2930
(704) 316-2938
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 316-1125
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2011031861
MO
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
2016-01044
NC
Other
Enumeration date
08/21/2008
Last updated
02/04/2019
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