Individual
ELISE ANN MAGGIONCALDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3623 LATROBE DR STE 216, CHARLOTTE, NC 28211-2117
(704) 332-1291
Mailing address
PO BOX 221249, CHARLOTTE, NC 28222-1249
(704) 332-1291
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
LL52684
SC
2085R0202X
Diagnostic Radiology Physician
Primary
2023-01751
NC
2085R0202X
Diagnostic Radiology Physician
ME169275
FL
2085R0202X
Diagnostic Radiology Physician
RTL19-0209
NC
Other
Enumeration date
06/14/2018
Last updated
02/05/2025
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