Individual
CHARLES A DEBERARDINIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
738 BRYANT ST, SUITE A, STATESVILLE, NC 28677-4189
(704) 873-1189
Mailing address
738 BRYANT ST, SUITE A, STATESVILLE, NC 28677-4189
(704) 873-1189
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
2010-00361
NC
207RC0000X
Cardiovascular Disease Physician
N1610
TX
207RI0011X
Interventional Cardiology Physician
201000361
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5913902
—
NC
Enumeration date
06/08/2006
Last updated
03/29/2021
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