Individual
KATHRYN CHANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
927 EAST BLVD, CHARLOTTE, NC 28203-5203
(704) 377-5772
Mailing address
2029 RADCLIFFE AVE, CHARLOTTE, NC 28207-2403
(704) 377-5772
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
154960
NC
207L00000X
Anesthesiology Physician
27553
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
152X0
BCBS
NC
05
—
1891917704
—
NC
05
—
NC1042
—
SC
01
—
P00789801
RAILROAD-MEDICARE
NC
Enumeration date
05/02/2007
Last updated
09/16/2015
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