Provider Demographics
NPI:1770735466
Name:NORTH CHARLOTTE PEDIATRICS PLLC
Entity type:Organization
Organization Name:NORTH CHARLOTTE PEDIATRICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SEWANYANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-941-0111
Mailing Address - Street 1:416 MCCULLOUGH DR
Mailing Address - Street 2:SUITE 416
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-4385
Mailing Address - Country:US
Mailing Address - Phone:704-941-0111
Mailing Address - Fax:
Practice Address - Street 1:416 MCCULLOUGH DR
Practice Address - Street 2:SUITE 416
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-4385
Practice Address - Country:US
Practice Address - Phone:704-941-0111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-14
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200500253208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty