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Individual

JOHN P EBERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
200 PROVIDENCE RD, SUITE101, CHARLOTTE, NC 28207-1468
(704) 749-5800
(704) 749-5819
Mailing address
200 PROVIDENCE RD, SUITE 101, CHARLOTTE, NC 28207-1468
(704) 749-5800
(704) 749-5819

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
33231
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8929976
NC
Enumeration date
09/13/2005
Last updated
02/09/2012
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