Provider Demographics
NPI:1407595085
Name:SUPERIOR HEALTH MEDICAL, PLLC
Entity Type:Organization
Organization Name:SUPERIOR HEALTH MEDICAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISETTE
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:AKERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:980-322-9742
Mailing Address - Street 1:8022 PROVIDENCE RD UNIT 500-165
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-9719
Mailing Address - Country:US
Mailing Address - Phone:980-322-9742
Mailing Address - Fax:
Practice Address - Street 1:8322 PINEVILLE MATTHEWS RD STE 602
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-4823
Practice Address - Country:US
Practice Address - Phone:704-389-9040
Practice Address - Fax:704-396-8388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty