Individual
DR. PHAENARETE H OSAKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8401 MEDICAL PLAZA DR, SUITE 220, CHARLOTTE, NC 28262-8797
(704) 384-1570
(704) 384-1534
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-1570
(704) 384-1534
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
200501648
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5903660
—
NC
Enumeration date
06/28/2006
Last updated
10/25/2020
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