Organization
CENTER FOR QUALITY OF LIFE ISSUES PLLC
Active
Organization
CENTER FOR QUALITY OF LIFE ISSUES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARYANN TRAXLER M.D. (OWNER)
(704) 540-0224
Entity
Organization
Contact information
Practice address
6429 BANNINGTON RD, STE B, CHARLOTTE, NC 28226-1344
(704) 540-0224
(704) 540-0694
Mailing address
6429 BANNINGTON RD, STE B, CHARLOTTE, NC 28226-1344
(704) 540-0224
(704) 540-0694
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9700784
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2247144A
P10 MEDICARE
NC
Enumeration date
05/11/2012
Last updated
05/11/2012
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