Individual
JULIO FERNANDO MATEUS NINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
905 KENILWORTH AVE, UNIT A, CHARLOTTE, NC 28204-1015
(704) 355-3149
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2018-00109
NC
207VM0101X
Maternal & Fetal Medicine Physician
2018-00109
NC
Other
Enumeration date
08/05/2007
Last updated
07/15/2024
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