Individual
CRYSTAL ROSE BULLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6845 FAIRVIEW RD STE 21, CHARLOTTE, NC 28210-3363
(910) 827-0535
(980) 249-4142
Mailing address
3525 REA FOREST DR, CHARLOTTE, NC 28226-3193
(910) 827-0535
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
2013-00024
NC
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
2013-00024
NC
Other
Enumeration date
07/02/2008
Last updated
11/14/2024
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