Individual
CARLA RAE NORDSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1350 S KINGS DR, CHARLOTTE, NC 28207-2134
(704) 446-4490
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
2017-02055
NC
207RP1001X
Pulmonary Disease Physician
Primary
2017-02055
NC
207RS0012X
Sleep Medicine (Internal Medicine) Physician
2017-02055
NC
Other
Enumeration date
05/08/2006
Last updated
07/15/2024
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