National Provider Identifier Database

PEACH STATE MEDICAL PRACTICE PC
Reproductive Endocrinology

An obstetrician/gynecologist who is capable of managing complex problems relating to reproductive endocrinology and infertility.


Contact Information

PEACH STATE MEDICAL PRACTICE, PC
420 PROVIDENCE RD
CHARLOTTE, NC28207
Phone: 855-563-2639
Fax:
Website:
Specialty Taxonomy Code
* Reproductive Endocrinology 207VE0102X
Gynecology 207VG0400X

* Indicates primary specialty

NPI Profile & details for PEACH STATE MEDICAL PRACTICE, PC

NPI Number 1801544093
Legal business name
LBN
PEACH STATE MEDICAL PRACTICE, PC
Authorized official FAHIMEH SASAN - (FOUNDING OBGYN)
Entity Organization
Organization subpart No
Enumeration date 03/16/2022
Last updated 05/20/2024 - About 2 years ago
Sole proprietor1 Not specified
Identifiers n/a

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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