Individual
TODD M LISTWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
501 S SHARON AMITY RD STE 300, CHARLOTTE, NC 28211-0035
(704) 377-2424
(704) 377-2687
Mailing address
501 S SHARON AMITY RD STE 300, CHARLOTTE, NC 28211-0035
(704) 377-2424
(704) 377-2687
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2008-00220
NC
207P00000X
Emergency Medicine Physician
230273
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1476K
BCBS
NC
05
—
59-08628
—
NC
05
—
N20008
—
SC
01
—
P00629319
RR MEDICARE
NC
Enumeration date
09/13/2006
Last updated
11/29/2018
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