Individual
CHARLES ALISON SIMONTON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1001 BLYTHE BLVD STE 300, CHARLOTTE, NC 28203-5863
(704) 373-0212
(704) 373-1216
Mailing address
PO BOX 60122, CHARLOTTE, NC 28260-0122
(704) 373-0212
(704) 373-1216
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
14424
SC
207R00000X
Internal Medicine Physician
28346
NC
207RC0000X
Cardiovascular Disease Physician
14424
SC
207RC0000X
Cardiovascular Disease Physician
Primary
28346
NC
207RI0011X
Interventional Cardiology Physician
14424
SC
207RI0011X
Interventional Cardiology Physician
28346
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
76354
BCBS
NC
05
—
8976354
—
NC
05
—
N28346
—
SC
01
—
P00205957
RAILROAD MEDICARE
—
Enumeration date
08/15/2006
Last updated
12/27/2007
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