Provider Demographics
NPI:1265486054
Name:CHEIFETZ, PAUL ADAM (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:ADAM
Last Name:CHEIFETZ
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3158 FREEDOM DR STE 3102
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208-0014
Mailing Address - Country:US
Mailing Address - Phone:704-971-7099
Mailing Address - Fax:704-971-0035
Practice Address - Street 1:920 COX RD STE 201
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-3435
Practice Address - Country:US
Practice Address - Phone:704-864-8302
Practice Address - Fax:704-971-0035
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2007-00522207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5906666Medicaid
SCN0052FMedicaid
NC2066075Medicare PIN