Most Relevant Information
Provider Data
| NPI Number: | 1003500091 |
| Provider Name: | SYDNEY THAMES DIAKALELA PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 0010-13213 |
Most Important Dates
| Enumeration Date: | 06/05/2023 |
| Last Updated: | 06/05/2023 |
Provider Practice Location
3570 TORINGDON WAY APT 1061
CHARLOTTE
NC
282774906
Practice Location Phone/Fax
| Phone: | 7048064717 |
| Fax: |
Provider Mailing Location
3570 TORINGDON WAY APT 1061
CHARLOTTE
NC
282774906
Provider Mailing Phone/Fax
| Phone: | 7048064717 |
| Fax: |