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Individual

DONOVAN THOMPSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3101 LATROBE DR, CHARLOTTE, NC 28211-4849
(704) 376-7362
Mailing address
3101 LATROBE DR, CHARLOTTE, NC 28211-4849
(704) 376-7362

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
37576
OK
207P00000X
Emergency Medicine Physician
Primary
9700780
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8910558
NC
05
N00780
SC
Enumeration date
07/14/2006
Last updated
03/17/2022
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