Provider Demographics
NPI:1366014540
Name:ABUNDANT HEALTH & VITALITY ASSOCIATES PLLC
Entity Type:Organization
Organization Name:ABUNDANT HEALTH & VITALITY ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MELODY
Authorized Official - Middle Name:
Authorized Official - Last Name:COVINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-997-9661
Mailing Address - Street 1:5970 FAIRVIEW RD STE 700
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-2114
Mailing Address - Country:US
Mailing Address - Phone:704-997-9661
Mailing Address - Fax:704-765-5760
Practice Address - Street 1:5970 FAIRVIEW RD STE 700
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-2114
Practice Address - Country:US
Practice Address - Phone:704-997-6661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-15
Last Update Date:2023-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity MedicineGroup - Single Specialty