| Atrium Health Musculoskeletal Institute Sports Medicine | |
|
3030 Randolph Rd Ste 105 Charlotte NC 28211-1368 | |
| (704) 863-4878 | |
| Not Available |
| Full Name | Atrium Health Musculoskeletal Institute Sports Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 3030 Randolph Rd, Charlotte, North Carolina |
| Authorized Official Name and Position | Scott Rissmiller (ENTERPRISE EVP) |
| Authorized Official Contact | 7043558675 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Atrium Health Musculoskeletal Institute Sports Medicine Po Box 19305 Charlotte NC 28219-9305 Ph: (704) 631-0002 | Atrium Health Musculoskeletal Institute Sports Medicine 3030 Randolph Rd Ste 105 Charlotte NC 28211-1368 Ph: (704) 863-4878 |
| NPI Number | 1639425796 |
|---|---|
| Provider Enumeration Date | 07/26/2012 |
| Last Update Date | 03/09/2023 |
| Medicare PECOS PAC ID | 3375449655 |
|---|---|
| Medicare Enrollment ID | O20130522000563 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639425796 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
| 207RS0010X | Internal Medicine - Sports Medicine | (* (Not Available)) | Secondary |
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