Individual
MICHAEL LEON TJAHJADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
728 HARTNESS RD, STATESVILLE, NC 28677-3425
(704) 360-6420
Mailing address
200 E 2ND AVE, GASTONIA, NC 28052-4358
(704) 874-1904
(704) 865-4614
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2023-02709
NC
Other
Enumeration date
06/04/2014
Last updated
07/28/2025
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