IndividualActive
Derek Medeiros, R.T, R.R.A, R.P.A
NPI 1053855296 · Radiology Practitioner Assistant · Charlotte, NC
Provider details
- NPI number
- 1053855296
- Entity type
- Individual
- Primary specialty
- Radiology Practitioner AssistantTechnologists, Technicians & Other Technical Service Providers
- Credential
- R.T, R.R.A, R.P.A
- Sex
- Male
- Sole proprietor
- Yes
- License
- 15MA1496 (MA)
Specialties & taxonomies
Technologists, Technicians & Other Technical Service Providers
Practice location
6836 Morrison Blvd Ste 101
Charlotte, NC 28211-2612
Phone: (704) 817-0821
Fax: (704) 817-0835
Approximate (ZIP-level) locationGet directions
Mailing address
6836 Morrison Blvd
Charlotte, NC 28211-2612
Registry dates
- Enumerated
- 2016-12-07
- Last updated
- 2016-12-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.