Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 2016-01797 | NC |
NPI | 1053758714 |
---|---|
Provider Name | Mona Walid Shaban |
First Address | Charlotte, NC 28204-3801 |
Second Address | Concord, NC 28025-2405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2013 |
Last Update Date | 04/12/2020 |