Individual
DR. LISA MAIDA BREITENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2413 E 5TH ST, CHARLOTTE, NC 28204-4340
(704) 351-5199
Mailing address
2413 E 5TH ST, CHARLOTTE, NC 28204-4340
(704) 351-5199
(704) 393-7368
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
30605
NC
Other
Enumeration date
02/17/2006
Last updated
07/08/2007
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