METROLINA SURGICAL SPECIALISTS, PLLC (NPI# 1871551911) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871551911 |
| Entity Type | Organization |
| Organization Name | METROLINA SURGICAL SPECIALISTS, PLLC |
| Practice Address |
1928 Randolph Rd Suite 312 Charlotte NC 28207-1105 |
| Practice Telephone | 7043750404 |
| Practice Fax Number | 7043750705 |
| Mailing Telephone | 7043750404 |
| Mailing Fax Number | 7043750705 |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | OBINNA NNAEMKA ERUCHALU (MANAGING MEMBER) |
| Authorized Official Telephone | 7043750404 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BLUE CROSS BLUE SHIELD | 1036L | 01 |
| NC | PARTNERS MEDICARE | 10039 | 01 |
| NC | 8930776 | 05 |
| Street Address |
1928 RANDOLPH RD SUITE 312 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28207-1105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841290525 | Emmett C Mathews Jr. | Internal Medicine | 1928 Randolph Rd, Ste 215, Charlotte, NC 28207-1105 | 2005-07-26 |
| 1700296951 | First Family Medical LLP | Internal Medicine | 1928 Randolph Rd, Ste 206, Charlotte, NC 28207-1105 | 2014-04-28 |
| 1982978706 | Kingsley Cadmus | Pharmacist | 1928 Randolph Rd, Suite 102, Charlotte, NC 28207-1105 | 2012-02-24 |
| 1497995450 | Emmett C. Mathews, Jr, Md Pa | Clinic/Center | 1928 Randolph Rd, Suite 215, Charlotte, NC 28207-1105 | 2009-03-03 |
| 1215102546 | Premier Sleep Services, LLC | Clinic/Center | 1928 Randolph Rd, Suite 111, Charlotte, NC 28207-1105 | 2008-04-28 |
| 1215107834 | Charlotte Womens Pavilion | Obstetrics & Gynecology | 1928 Randolph Rd, Suite 206, Charlotte, NC 28207-1105 | 2008-03-11 |
| 1356524037 | Comprehensive Foot and Ankle Center,pa | Podiatrist | 1928 Randolph Rd, Suite 214, Charlotte, NC 28207-1105 | 2007-12-17 |
| 1124061924 | Charles Chike Anikwue | Obstetrics & Gynecology | 1928 Randolph Rd, Ste. 206, Charlotte, NC 28207-1105 | 2006-06-13 |
| 1013984996 | William Sumner Logan | Specialist | 1928 Randolph Rd, Suite 316, Charlotte, NC 28207-1105 | 2006-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013560739 | Louis Roncaglione | Dentist | 8815 Christenbury Pkway, Concord, NC 28207 | 2019-07-22 |
| 1619430014 | Khrystyna Levytska | Student in an Organized Health Care Education/Training Program | Myers Park Clinic Ob/gyn, 1350 S. Kings Dr., Charlotte, NC 28207 | 2019-04-11 |
| 1649743584 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 1005 South Kings Drive, Charlotte, NC 28207 | 2019-01-03 |
| 1023584489 | Herron and Smith Associates, Pllc | Dentist | 135 Perrin Place, Suite 100, Charlotte, NC 28207 | 2018-10-23 |
| 1588161640 | Lauren Mogk | Student in an Organized Health Care Education/Training Program | Myers Park Clinical Internal Medicine, 1350 S. Kings Dr., 3rd Floor, Charlotte, NC 28207 | 2018-04-06 |
| 1518462241 | Sarah Hollyn Carlock | Student in an Organized Health Care Education/Training Program | Myers Park Clinic Internal Medicine, 1350 S Kings Dr, 3rd Floor, Charlotte, NC 28207 | 2018-03-26 |
| 1083118178 | Claire Milam | Student in an Organized Health Care Education/Training Program | Cmc/department of Emergency Medicine, 100 Blythe Blvd, Charlotte, NC 28207 | 2018-03-22 |
| 1811422256 | Complete Care At Dartmouth LLC | Skilled Nursing Facility | 300 Province Road, Charlotte, NC 28207 | 2017-04-24 |
| 1063945467 | Kaitlyn O'keefe | Internal Medicine | 1350 S. Kings Dr., 3rd Floor, Myers Park Clinic Internal Medicine, Charlotte, NC 28207 | 2017-04-04 |
| 1811432024 | Advanced Prosthetics of Easley, Inc | Durable Medical Equipment & Medical Supplies | 2310 Randolph Rd Ste A, Charlotte, NC 28207 | 2016-12-23 |
| Find all providers in zip 28207 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598252207 | Kim Dudley | Specialist | 9208 Ardrey Kell Rd Ste 14, Charlotte, NC 28277-0786 | 2018-04-18 |
| 1568828994 | Darla Lilleberg | Specialist | 428 E 4th St, Suite 333, Charlotte, NC 28202-2434 | 2016-01-14 |
| 1508222175 | Candy Sue Benish | Specialist | 3349 Chilham Pl, Charlotte, NC 28226-3000 | 2016-01-12 |
| 1245614874 | Joseph Franklin Cline | Specialist | 8133 Ardrey Kell Rd Ste 203, Charlotte, NC 28277-5723 | 2015-07-14 |
| 1689055147 | James Salfia | Specialist | 9608 Rainbow Forest Dr, Charlotte, NC 28277-8773 | 2015-06-10 |
| 1811384720 | Diabetes and Metabolism Care Group Pllc | Specialist | 10344 Park Rd, Charlotte, NC 28210-8470 | 2015-04-17 |
| 1730579657 | Queen Charlotte Hair Replacement Center | Specialist | 5729 Cedars East Ct Apt 6, Charlotte, NC 28212-0192 | 2015-01-30 |
| 1285046573 | Said Yousef | Specialist | 8706 Holly Creek Ct, Charlotte, NC 28216-2666 | 2014-05-21 |
| 1235564758 | Barbara Jo Halton-bailey | Specialist | 231 Old Bell Rd, Charlotte, NC 28270-2792 | 2013-09-04 |
| 1508206061 | Amalia Cisneros | Specialist | 5800 N Sharon Amity Rd Ste B, Charlotte, NC 28215-5081 | 2013-06-28 |
| Find all providers in CHARLOTTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.