Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Grace Pediatric Clinic, PA

Organization Pediatrics Physician · NPI 1447307384

Grace Pediatric Clinic, PA is a Pediatrics Physician in Charlotte, North Carolina. Licensed in North Carolina. Registered with an NPI since 2007.

Licensed in
NC
In the registry since
2007
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2401 Tuckaseegee Rd
Charlotte, NC 28208-4058
Phone: (704) 409-3000
Fax: (704) 409-2382
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 9800405 (NC)

Record details

NPI number1447307384
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Julius Tokunboh — Medical Director · (709) 409-3000
NPI enumeratedJanuary 4, 2007
Last updated in NPPESAugust 22, 2020
Mailing address2401 Tuckaseegee Rd, Charlotte, NC 28208-4058

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