Konzer, Tia Rene'

Konzer, Tia Rene' is an individual health care provider with primary practice located at 1900 Randolph Rd , Charlotte NC 28207-1122. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry is her primary health care specialty. Konzer, Tia Rene' can be contacted via phone (704) 384-1246.

Contact Information

Primary practice address
1900 Randolph Rd Charlotte NC 28207-1122
Phone: (704) 384-1246
Fax: (704) 384-6072
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 5101016063 Michigan
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 2009-01442 North Carolina
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 2009-01442 North Carolina

Profile Details

NPI number 1477689578
LBN Legal business name Konzer, Tia Rene'
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 26th, 2007
Last updated Nov 24th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477689578 NPPES
North Carolina MEDICAID 5912201

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