Larson, Tracy M

Larson, Tracy M is an individual health care provider with primary practice located at 6401 Morrison Blvd # 2A , Charlotte NC 28211-3800. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Larson, Tracy M can be contacted via phone (704) 390-7150.

Contact Information

Primary practice address
6401 Morrison Blvd # 2A Charlotte NC 28211-3800
Phone: (704) 390-7150
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 9900925 North Carolina

Profile Details

NPI number 1285637207
LBN Legal business name Larson, Tracy M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2005
Last updated Jan 31st, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285637207 NPPES
South Carolina MEDICAID NC2421
South Carolina MEDICAID 1285637207

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