Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301087311 | MI |
N | 111NI0900X | Internist | 4301087311 | MI |
Y | 207RX0202X | Medical Oncology | 2012-00964 | NC |
NPI | 1073615654 |
---|---|
Provider Name | Michael Axelson |
First Address | Charlotte, NC 28207-2034 |
Second Address | Charlotte, NC 28207-2034 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2006 |
Last Update Date | 16/05/2013 |