Albert Petrus Wirawan, RN, NP-C, MSN | |
200 Hawthorne Ln, Charlotte, NC 28204-2515 | |
(704) 384-5416 | |
(704) 384-5992 |
Full Name | Albert Petrus Wirawan |
---|---|
Gender | Male |
Speciality | Nurse Practitioner |
Experience | 13 Years |
Location | 200 Hawthorne Ln, Charlotte, North Carolina |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1831461987 | NPI | - | NPPES |
1831461987 | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 5005467 (North Carolina) | Secondary |
363L00000X | Nurse Practitioner | 5005467 (North Carolina) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Novant Medical Group Inc | 1153234893 | 2023 |
Entity Name | Novant Medical Group Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1366409492 PECOS PAC ID: 1153234893 Enrollment ID: O20031121000692 |
Entity Name | Cogent Healthcare Of North Carolina Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1548207483 PECOS PAC ID: 7911954714 Enrollment ID: O20050404001057 |
Mailing Address | Practice Location Address |
---|---|
Albert Petrus Wirawan, RN, NP-C, MSN Po Box 60447, Charlotte, NC 28260-0447 Ph: (704) 384-5416 | Albert Petrus Wirawan, RN, NP-C, MSN 200 Hawthorne Ln, Charlotte, NC 28204-2515 Ph: (704) 384-5416 |
Melissa E Jesse, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2236 Shenandoah Ave, Charlotte, NC 28205 Phone: 704-999-9857 | |
Mrs. Adrienne Dunlap Lane, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 200 Hawthorne Ln, Charlotte, NC 28204 Phone: 704-384-4109 | |
Melissa Renee Flood, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1225 Harding Pl, Ste 5100, Charlotte, NC 28204 Phone: 704-355-8850 | |
Anna Philbeck Burgess, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4135 Southstream Blvd, Charlotte, NC 28217 Phone: 704-631-1200 | |
Stephanie Dawn Ferlic, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 6900 Farmingdale Dr, Charlotte, NC 28212 Phone: 704-910-5810 | |
Brooke Alyssa Davis, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2711 Randolph Rd Ste 400, Charlotte, NC 28207 Phone: 704-342-1900 Fax: 704-377-0353 | |
Angela Devincent Booth, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1001 Blythe Blvd, Medical Center Plaza Suite 200, Charlotte, NC 28203 Phone: 704-381-8840 |