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Contact Information

CATHERINE J BORDEAUX, PA
3030 RANDOLPH RD
CHARLOTTE, NC28211-1368
 Phone: 704-512-4450
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for CATHERINE J BORDEAUX · (Female)

NPI Number 1013099142
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 10/19/2006
Last updated 08/01/2017 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • NC License # 0010-07164
  • VA Medicaid 007601328
  • VA Other 5209080 AETNA
  • VA Other 140457 ANTHEM
  • VA Other 213427 CIGNA
  • VA Other 432612 MAMSI/ALLIANCE
  • VA Other 620043172 RAILROAD MEDICARE
  • VA Other 54536 SENTARA/OPTIMA
  • VA Other 121242 SOUTHERN HEALTH
  • VA Other 541913625 TAXONOMY
Hospital affiliation(s)
  • CAROLINAS MEDICAL CENTER/BEHAV HEALTH - (Acute Care)
    1000 BLYTHE BLVD
    CHARLOTTE, NC 28203
  • ST LUKES HOSPITAL - (Critical Access)
    101 HOSPITAL DRIVE
    COLUMBUS, NC 28722
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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