Individual
MRS. BRANDIE ROSE BUCKINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2711 RANDOLPH RD, BLDG 400, CHARLOTTE, NC 28207-2034
(704) 348-2992
(704) 971-0035
Mailing address
1300 BAXTER ST, STE 215, CHARLOTTE, NC 28204-3053
(704) 332-0396
(704) 971-0035
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-04904
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689090474
—
NC
05
—
1852PA
—
SC
Enumeration date
03/17/2014
Last updated
10/04/2023
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