Individual
MACY RENAE OSBORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
106 LANGTREE VILLAGE DR STE 200, MOORESVILLE, NC 28117-7594
(704) 384-7101
(704) 384-7102
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2022-00706
NC
207Q00000X
Family Medicine Physician
250274
NC
Other
Enumeration date
04/23/2019
Last updated
08/19/2022
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