Individual
FRED D. LASSITER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 E MOREHEAD ST, STE 300, CHARLOTTE, NC 28202-2788
(704) 334-7800
Mailing address
700 E MOREHEAD ST, STE 300, CHARLOTTE, NC 28202-2788
(704) 334-7800
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
9801350
NC
2085R0202X
Diagnostic Radiology Physician
101053630
VA
2085R0202X
Diagnostic Radiology Physician
22382
SC
2085R0202X
Diagnostic Radiology Physician
Primary
9801350
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89129P3
—
NC
Enumeration date
07/14/2005
Last updated
12/20/2017
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