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4949 Professional Park Dr Ste 101 Kannapolis NC 28081-8637 | |
| (704) 938-6521 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 4949 Professional Park Dr, Kannapolis, 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 |
|---|---|
Po Box 19305 Charlotte NC 28219-9305 Ph: (704) 631-0002 | 4949 Professional Park Dr Ste 101 Kannapolis NC 28081-8637 Ph: (704) 938-6521 |
| NPI Number | 1518197458 |
|---|---|
| Provider Enumeration Date | 07/24/2009 |
| Last Update Date | 03/09/2023 |
| Medicare PECOS PAC ID | 3375449655 |
|---|---|
| Medicare Enrollment ID | O20100930006964 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518197458 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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