Organization
HERITAGE REGENERATIVE MEDICINE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN EVANS STAVRAKOS MD (OWNER)
(574) 386-1846
Entity
Organization
Contact information
Practice address
8058 CORPORATE CENTER DR STE 300, CHARLOTTE, NC 28226-4560
(980) 210-0079
Mailing address
8058 CORPORATE CENTER DR STE 300, CHARLOTTE, NC 28226-4560
(980) 210-0079
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
01/20/2025
Last updated
01/20/2025
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