Provider Demographics
NPI:1043241391
Name:REPRODUCTIVE ENDOCRINOLOGY ASSOCIATES OF CHARLOTTE
Entity Type:Organization
Organization Name:REPRODUCTIVE ENDOCRINOLOGY ASSOCIATES OF CHARLOTTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:FLATTERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-343-3400
Mailing Address - Street 1:1524 E MOREHEAD ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207-1606
Mailing Address - Country:US
Mailing Address - Phone:704-343-3400
Mailing Address - Fax:704-343-3428
Practice Address - Street 1:1524 E MOREHEAD ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-1606
Practice Address - Country:US
Practice Address - Phone:704-343-3400
Practice Address - Fax:704-343-3428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty