Individual
CHARNETTE H SHADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
91 ENTERPRISE DR, ROCKY MOUNT, NC 27804-9590
(252) 451-3100
(252) 937-3106
Mailing address
PO BOX 7200, ROCKY MOUNT, NC 27804-0200
(252) 937-0200
(252) 451-0056
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
200400745
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
137AJ
BCBSNC
NC
01
—
1902525
UNITED HEALTH CARE
NC
05
—
89137AJ
—
NC
01
—
9568009
CIGNA HEALTHCARE
NC
01
—
D5324
MEDCOST
NC
Enumeration date
09/08/2005
Last updated
03/26/2026
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