Most Relevant Information
Provider Data
| NPI Number: | 1003376534 |
| Provider Name: | NICOLE LUDMIL IVANOV MD |
| Entity Type: | Individual |
| Taxonomy Code: | 208000000X |
| Specialty: | Pediatrics |
| License Number: | 2022-01947 |
Most Important Dates
| Enumeration Date: | 03/21/2019 |
| Last Updated: | 07/15/2024 |
Provider Practice Location
9908 COULOAK DR
STE 103
CHARLOTTE
NC
282168678
Practice Location Phone/Fax
| Phone: | 7048012025 |
| Fax: |
Provider Mailing Location
PO BOX 19305
CHARLOTTE
NC
282199305
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |
Suggested EMR
Pediatrics EMR