Individual
MR. LUIS M PEREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
230 BALDWIN AVE, CHARLOTTE, NC 28204-3110
(704) 376-5636
(704) 376-5933
Mailing address
230 BALDWIN AVE, CHARLOTTE, NC 28204-3110
(704) 376-5636
(704) 376-5933
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
38823
NC
2088P0231X
Pediatric Urology Physician
38823
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891279M
—
NC
05
—
G38823
—
SC
Enumeration date
11/30/2005
Last updated
07/21/2022
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