Individual
JASON LY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1000 BLYTHE BLVD FL 4, CHARLOTTE, NC 28203-5812
(704) 381-6800
Mailing address
1000 BLYTHE BLVD FL 4, CHARLOTTE, NC 28203-5812
(704) 381-6800
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0102209178
VA
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
0102209178
VA
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
2026-01173
NC
Other
Enumeration date
03/26/2022
Last updated
03/19/2026
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