Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 164526 | NC |
NPI | 1003132242 |
---|---|
Provider Name | Chelsea Kolshak |
First Address | Charlotte, NC 28203-5812 |
Second Address | Charlotte, NC 28203-5812 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2010 |
Last Update Date | 21/12/2011 |