Tidwell, John W.

Tidwell, John W. is an individual health care provider with primary practice located at 2801 Randolph Rd Ste 200, Charlotte NC 28211-1051. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Tidwell, John W. can be contacted via phone (704) 377-5675.

Contact Information

Primary practice address
2801 Randolph Rd Ste 200 Charlotte NC 28211-1051
Phone: (704) 377-5675
Fax: (704) 335-8163
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 17907 North Carolina

Profile Details

NPI number 1790781805
LBN Legal business name Tidwell, John W.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2005
Last updated Jul 8th, 2007 - about 19 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 1790781805 NPPES
North Carolina MEDICAID 8983480
North Carolina MEDICAID N17907

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