Individual
MR. TAJ YUSEF HUBBARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12430 DOWNY BIRCH RD, CHARLOTTE, NC 28227-3675
(704) 606-5013
Mailing address
12430 DOWNY BIRCH RD, CHARLOTTE, NC 28227-3675
(704) 606-5013
Taxonomy
Speciality
Code
Description
License number
State
132700000X
Dietary Manager
—
—
133N00000X
Nutritionist
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
172A00000X
Driver
—
—
173000000X
Legal Medicine
—
—
305R00000X
Preferred Provider Organization
—
—
305S00000X
Point of Service
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
05/21/2012
Last updated
05/21/2012
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