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

Queens University of Charlotte

Organization Sports Medicine (Family Medicine) Physician · NPI 1457986515

Queens University of Charlotte is a Sports Medicine (Family Medicine) Physician in Charlotte, North Carolina. Registered with an NPI since 2020.

In the registry since
2020

Practice location Address checks out

1900 Selwyn Ave
Charlotte, NC 28274-0001
Phone: (972) 367-4845
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Family Medicine) Physician (primary) Taxonomy 207QS0010X

Record details

NPI number1457986515
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mouzon Bass — Administrator/Agent · (972) 367-4845
Other names Queens Sports Medicine
NPI enumeratedMarch 10, 2020
Last updated in NPPESMarch 10, 2020
Certification dateMarch 10, 2020
Mailing address5050 Spring Valley Rd, Dallas, TX 75244-3995

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