Individual
EDWIN WAYNE SPARKS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
501 BILLINGSLEY RD, STE B, CHARLOTTE, NC 28211-1009
(704) 444-2400
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
9401342
NC
2084P0800X
Psychiatry Physician
Primary
9401342
NC
Other
Enumeration date
07/20/2006
Last updated
07/15/2024
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