Individual
ARTEM DERKACHEV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4104 N COURSE DR, CHARLOTTE, NC 28277-7612
(704) 773-7829
Mailing address
4104 N COURSE DR, CHARLOTTE, NC 28277-7612
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28312
NC
Other
Enumeration date
11/14/2018
Last updated
11/14/2018
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