Provider Demographics
NPI:1518096080
Name:EASON, RENITA PATRYCE (MD)
Entity Type:Individual
Prefix:DR
First Name:RENITA
Middle Name:PATRYCE
Last Name:EASON
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9201 UNIVERSITY CITY BLVD STUDENT HEALTH CENTER
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28223-0001
Mailing Address - Country:US
Mailing Address - Phone:704-687-7400
Mailing Address - Fax:704-687-1801
Practice Address - Street 1:9201 UNIVERSITY CITY BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28223
Practice Address - Country:US
Practice Address - Phone:704-687-7400
Practice Address - Fax:704-687-1801
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC200701899207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine