Registry details
Type
Individual
Primary specialty
Internal Medicine, Medical Oncology
Enumerated
Aug 16, 2011
License(s)
2023-01793 (NC), 293267 (NY), MT199197 (PA), 2023-01793 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 170 MEDICAL PARK RD STE 101 | Mooresville, NC 28117-8541 | 980-302-7070 |
| MAILING | PO BOX 60447 | Charlotte, NC 28260-0447 |
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