Individual
ILAN D AVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2104 RANDOLPH RD, CHARLOTTE, NC 28207-1522
(704) 377-3900
(704) 377-1244
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2012-02326
NC
Other
Enumeration date
08/12/2006
Last updated
01/24/2022
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