Individual
DR. LARS THESTRUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 BLYTHE BLVD, CHARLOTTE, NC 28203-5812
(704) 355-3181
Mailing address
1000 BLYTHE BLVD, CHARLOTTE, NC 28203-5812
(704) 355-3181
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0101240821
VA
207P00000X
Emergency Medicine Physician
2007-00434
NC
207P00000X
Emergency Medicine Physician
Primary
N2839
TX
2085U0001X
Diagnostic Ultrasound Physician
2007-00434
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
145WC
NCBCBS
NC
05
—
5906799
—
NC
05
—
N0043B
—
SC
Enumeration date
01/26/2007
Last updated
03/10/2020
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