| Carolina Neuroservices | |
|
6853 Fairview Rd Suite B Charlotte NC 28210-3363 | |
| (704) 366-9930 | |
| Not Available |
| Full Name | Carolina Neuroservices |
|---|---|
| Speciality | Clinic/Center |
| Location | 6853 Fairview Rd, Charlotte, North Carolina |
| Authorized Official Name and Position | Peter Jeffrey Ewert (PRESIDENT) |
| Authorized Official Contact | 7043669930 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina Neuroservices 6853 Fairview Rd Ste B Charlotte NC 28210-3363 Ph: (704) 366-9930 | Carolina Neuroservices 6853 Fairview Rd Suite B Charlotte NC 28210-3363 Ph: (704) 366-9930 |
| NPI Number | 1780684522 |
|---|---|
| Provider Enumeration Date | 07/22/2005 |
| Last Update Date | 09/25/2009 |
| Medicare PECOS PAC ID | 8123095098 |
|---|---|
| Medicare Enrollment ID | O20040911000207 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780684522 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Peter J Ewert |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1730188020 PECOS PAC ID: 8527035484 Enrollment ID: I20040911000133 |
| Provider Name | Ashley M Flint |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982072781 PECOS PAC ID: 5496015604 Enrollment ID: I20180208001524 |
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