Basic Information
| Provider Information | |||||||||
| NPI: | 1457589970 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCKEE | ||||||||
| FirstName: | ELLIOT | ||||||||
| MiddleName: | CAPERS | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6035 FAIRVIEW RD | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282103256 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7042953000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 400 PARK ST | ||||||||
| Address2: | |||||||||
| City: | BELMONT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280123368 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7042953700 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2009 | ||||||||
| LastUpdateDate: | 04/23/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | 11015076A | IN | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207W00000X | 2013-007258 | NC | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
ID Information
| ID | Type | State | Issuer | Description | P01510186 | 01 | NC | RAILROAD MEDICARE | OTHER | Q0072T | 05 | SC | MEDICAID | 180P9 | 01 | NC | BCBS | OTHER | 30183028 | 01 | SC | SELECT HEALTH | OTHER | NCD318B | 01 | NC | MEDICARE | OTHER |