Individual
ILYA ALISHAYEV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
101 E WT HARRIS BLVD, STE 5002, CHARLOTTE, NC 28262-3485
(704) 801-7310
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2016-00823
NC
Other
Enumeration date
06/14/2010
Last updated
09/25/2020
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