| Carolina Neurological Clinic, Pa | |
|
3541 Randolph Rd Suite 101 Charlotte NC 28211-1082 | |
| (704) 377-9323 | |
| (704) 331-4030 |
| Full Name | Carolina Neurological Clinic, Pa |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 3541 Randolph Rd, Charlotte, North Carolina |
| Authorized Official Name and Position | Shepard Averitt (ADMINISTRATOR) |
| Authorized Official Contact | 7043779323 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina Neurological Clinic, Pa Po Box 221009 Charlotte NC 28222-1009 Ph: (704) 377-9323 | Carolina Neurological Clinic, Pa 3541 Randolph Rd Suite 101 Charlotte NC 28211-1082 Ph: (704) 377-9323 |
| NPI Number | 1902861396 |
|---|---|
| Provider Enumeration Date | 04/19/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902861396 | NPI | - | NPPES |
| 8901287 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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