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 provides Pediatrics Physician services 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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