Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 22834 | NC |
N | 2080A0000X | Adolescent Medicine | 22834 | NC |
NPI | 1205362639 |
---|---|
Provider Name | Dr. Susan Scarlett |
First Address | Charlotte, NC 28217-1309 |
Second Address | Hickory, NC 28602-9695 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2017 |
Last Update Date | 04/05/2017 |