QUEEN CITY PLASTIC SURGERY PLLC (NPI# 1225437643) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225437643 |
| Entity Type | Organization |
| Organization Name | QUEEN CITY PLASTIC SURGERY PLLC |
| Practice Address |
3025 Springbank Ln Suite 240 Charlotte NC 28226-3362 |
| Practice Telephone | 7043725685 |
| Practice Fax Number | 7043725686 |
| Mailing Telephone | 7043725685 |
| Mailing Fax Number | 7043725686 |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2017-03-20 |
| Authorized Official Name | ENAMUAL HAQUE (OWNER) |
| Authorized Official Telephone | 7043725685 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208200000X | Plastic Surgery | 200901161 | NC | Allopathic & Osteopathic Physicians |
| Street Address |
3025 SPRINGBANK LN SUITE 240 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28226-3362 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942206131 | Michelle Scullock | Internal Medicine | 3025 Springbank Ln, Ste 100, Charlotte, NC 28226-3362 | 2005-06-22 |
| 1376052753 | Daniel Zalinov | Physician Assistant | 3025 Springbank Ln, Ste 100, Charlotte, NC 28226-3362 | 2017-09-28 |
| 1396264503 | Lauren Foley | Nurse Practitioner | 3025 Springbank Ln, Ste 100, Charlotte, NC 28226-3362 | 2017-09-19 |
| 1144744681 | Amanda Konopka | Nurse Practitioner | 3025 Springbank Ln, Ste 100, Charlotte, NC 28226-3362 | 2017-07-26 |
| 1790147940 | William Shimberg | Internal Medicine | 3025 Springbank Ln, Ste 100, Charlotte, NC 28226-3362 | 2016-03-27 |
| 1134485964 | Laura Hahn | Internal Medicine | 3025 Springbank Ln, Suite 100, Charlotte, NC 28226-3362 | 2012-04-05 |
| 1154646578 | Charlotte Medical Clinic Inc | Family Medicine | 3025 Springbank Ln, Ste 100, Charlotte, NC 28226-3362 | 2010-03-29 |
| 1396078424 | April Ihne Madaris | Optometrist | 3025 Springbank Ln, Suite 200, Charlotte, NC 28226-3362 | 2009-09-08 |
| 1447487186 | Kristina Coffey | Physician Assistant | 3025 Springbank Ln, Ste 100, Charlotte, NC 28226-3362 | 2009-06-21 |
| 1679719843 | Betancourt,pinnix, Phelps, &grimes, Dmd Pllc | Dentist | 3025 Springbank Ln, Suite 250, Charlotte, NC 28226-3362 | 2008-12-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841837507 | Southeast Vulvar Clinic, Pllc | Dermatology | 6406 Carmel Road, Suite 309, Charlotte, NC 28226 | 2019-12-02 |
| 1427540012 | Kenneth William Riley Jr. | Behavioral Analyst | 10953 Park Rd., Charlotte, NC 28226 | 2018-05-31 |
| 1780103838 | Tamara Andres | Specialist/Technologist | 2518 Lawton Bluff Rd., Charlotte, NC 28226 | 2017-09-10 |
| 1083132609 | Xenon Anesthesia of North Carolina Pllc | Anesthesiology | 7006 Shannon Willow Road, Charlotte, NC 28226 | 2017-09-04 |
| 1104354117 | Lauren Nicole Brindisi | Chiropractor | 11230 Carmel Commons Blvd., Charlotte, NC 28226 | 2017-06-03 |
| 1346790821 | Carolinas Skin Center Pa | Plastic Surgery | 3315 Springbank Lane, Suite 202, Charlotte, NC 28226 | 2016-10-10 |
| 1871040469 | Julie R Jackson | Counselor | 7810 Prineville-mathews Road, Charlotte, NC 28226 | 2016-09-01 |
| 1518346105 | Christopher Abernathy | Dentist | 3111 Springbank Ln Ste A, Charlotte, NC 28226 | 2015-05-28 |
| 1285067504 | Amy N Bullock | Physical Therapist | 7207 Marcel Ln Apt 1138, Charlotte, NC 28226 | 2013-08-11 |
| 1528405297 | Elevate Counseling and Clinical Services, Pllc | Community/Behavioral Health | 107220 Carmel Commons Blvd., Ste. 320, Charlotte, NC 28226 | 2013-06-04 |
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| Taxonomy Code | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346790821 | Carolinas Skin Center Pa | Plastic Surgery | 3315 Springbank Lane, Suite 202, Charlotte, NC 28226 | 2016-10-10 |
| 1639479595 | Edward Joseph Bednar | Plastic Surgery | 439 N Wendover Rd, Charlotte, NC 28211-1064 | 2010-10-26 |
| 1053452615 | Jarrod Ryan Daniel | Plastic Surgery | 2215 Randolph Road, Charlotte, NC 28207 | 2007-02-08 |
| 1255479895 | Adam Christian Augenstein | Plastic Surgery | 11835 Southmore Dr, Ste 202, Charlotte, NC 28277-4466 | 2007-02-04 |
| 1851452296 | Kenneth Penn Bullard | Plastic Surgery | 1225 Charter Place, Charlotte, NC 28211-5503 | 2006-12-12 |
| 1144328493 | Michael H Carstens | Plastic Surgery | 1719 South Blvd # B, Charlotte, NC 28203-4727 | 2006-09-20 |
| 1902888977 | Hope Sherie | Plastic Surgery | 325 Arlington Ave # B, Charlotte, NC 28203-4271 | 2005-11-16 |
| 1124029707 | Gregory Allen Mantooth | Plastic Surgery | 5815 Blakeney Park Dr Ste 100, Charlotte, NC 28277-5732 | 2005-08-09 |
| 1912370602 | Aesthetic Surgery of Charlotte Pllc | Plastic Surgery | 11835 Southmore Dr, Suite 202, Charlotte, NC 28277-4466 | 2015-11-04 |
| 1316246788 | Jason Korn | Plastic Surgery | 1025 Morehead Medical Dr, Ste 200, Charlotte, NC 28204-2963 | 2011-03-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.