Queen City Plastic Surgery PLLC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

200901161 Issued in NC

Legal business name

QUEEN CITY PLASTIC SURGERY PLLC

Practice address

3025 Springbank LN
Suite 240
Charlotte, NC 28226-3362

Phone

(704) 372-5685

Fax

(704) 372-5686

NPI assigned

Aug 21, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Enamual Haque, MD

Title

Owner

Phone

(704) 372-5685

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Enamul Haque, M.D.

  • Surgery of the Hand (Surgery) Physician
  • Charlotte, NC
  • NPI 1144351693
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489968000000",
    "number": "1225437643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3025 SPRINGBANK LN",
            "address_2": "SUITE 240",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282263362",
            "telephone_number": "704-372-5685",
            "fax_number": "704-372-5686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3025 SPRINGBANK LN",
            "address_2": "SUITE 240",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282263362",
            "telephone_number": "704-372-5685",
            "fax_number": "704-372-5686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEEN CITY PLASTIC SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-21",
        "last_updated": "2017-03-20",
        "status": "A",
        "authorized_official_last_name": "HAQUE",
        "authorized_official_first_name": "ENAMUAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-372-5685",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "NC",
            "license": "200901161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Queen City Home Care LLC
• Queen City Laboratory Services, PLLC
• Queen City Labs, LLC
• Queen City Pelvic PT
• Queen City Pharmacy LLC
• Queen City Psychotherapy PLLC
• Queen City Rehab and Sports Performance, LLC
• Queen City Speech
• Queen City Therapy, PLLC
• Alison Victoria Queen-Wehrung I

• Plastic Surgery Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Plastic Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.