Individual
KARLTON SHEA PETTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 S TORRENCE ST, STE 100, CHARLOTTE, NC 28204-3077
(704) 372-9393
(704) 372-0135
Mailing address
700 S TORRENCE ST, STE 100, CHARLOTTE, NC 28204-3077
(704) 372-9393
(704) 372-0135
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
200301510
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2025155
MEDICARE LEGACY NUMBER
FL
05
—
89136C1
—
FL
Enumeration date
04/03/2006
Last updated
02/24/2017
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