Charlotte Medical Clinic
Internal Medicine Physician in Charlotte, NC(View on Map)
Legal Business Name
Charlotte Medical Clinic
NPI Number
1083649214
NPI Type
Organization
Enumeration Date
07/12/2006
Specialties
(Taxonomies)Name
Code
207R00000X
207RC0000X
207N00000X
207RE0101X
207RG0100X
208100000X
207RP1001X
207RR0500X
Primary Taxonomy
Yes
No
No
No
No
No
No
No
Contact
Information
Purpose
Mailing
Location
Address
PO BOX 601643
1001 BLYTHE BLVD
City
Charlotte
Charlotte
State
NC
NC
Postal Code
28260-1643
28203-5874
Country
US
US
Telephone Number
(704) 355-5100
(704) 355-5100
Authorized Official
Name
Daniel Wiens
Title or Position
SENIOR VICE PRESIDENT
Telephone Number
(704) 355-0648
Identifiers
Identifier
89012Y0
Identifier State
NC
Identifier Issuer
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 09/09/2008
Provider Address
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