Provider Demographics
NPI:1568667335
Name:HITE, NOEL H (CP)
Entity Type:Individual
Prefix:
First Name:NOEL
Middle Name:H
Last Name:HITE
Suffix:
Gender:M
Credentials:CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2096 CHAPEL CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-7837
Mailing Address - Country:US
Mailing Address - Phone:651-335-3797
Mailing Address - Fax:
Practice Address - Street 1:8310 MEDICAL PLAZA DR
Practice Address - Street 2:SUITE C
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-6701
Practice Address - Country:US
Practice Address - Phone:704-510-1300
Practice Address - Fax:704-510-1311
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCP0035211744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7795365OtherMEDICAID INDIVIDUAL
NCDE1110Medicaid
NC7703168Medicaid
NC7703168Medicaid
NC562182959OtherEIN