Individual
CHARLES EDWIN STODDARD III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
433 COPPERFIELD BLVD NE, CONCORD, NC 28025-2405
(704) 786-7770
(704) 788-9351
Mailing address
3158 FREEDOM DR STE 3102, CHARLOTTE, NC 28208-0014
(704) 971-7099
(704) 971-0035
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
200400604
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
144A6
BCBS
—
01
—
1624358
CIGNA HEALTHCARE
—
05
—
5906397
—
NC
01
—
807633
PARTNERS MEDICARE
—
Enumeration date
09/07/2006
Last updated
04/02/2025
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