Individual
GRACE CRUZ PAMINTUAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10616 METROMONT PKWY, SUITE 104, CHARLOTTE, NC 28269
(704) 921-6659
(704) 921-6698
Mailing address
10616 METROMONT PKWY, SUITE 104, CHARLOTTE, NC 28269
(704) 921-6659
(704) 921-6698
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
9700121
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891070P
—
NC
Enumeration date
01/16/2007
Last updated
03/14/2014
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