Individual
JERRY WITHROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9332 S TRYON ST, CHARLOTTE, NC 28273-3108
(704) 587-6700
Mailing address
9332 S TRYON ST, CHARLOTTE, NC 28273-3108
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27541
NC
207Q00000X
Family Medicine Physician
36635
SC
Other
Enumeration date
07/19/2006
Last updated
02/12/2019
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