| Carolina Cardiology, Sleep & Obesity Center Pc | |
|
3280 Henderson Dr Ste C Jacksonville NC 28546-5290 | |
| (910) 915-8450 | |
| Not Available |
| Full Name | Carolina Cardiology, Sleep & Obesity Center Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3280 Henderson Dr Ste C, Jacksonville, North Carolina |
| Authorized Official Name and Position | Shyamal Kishore Mitra (OWNER) |
| Authorized Official Contact | 2525253290 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina Cardiology, Sleep & Obesity Center Pc 3280 Henderson Dr Ste C Jacksonville NC 28546-5290 Ph: (910) 915-8450 | Carolina Cardiology, Sleep & Obesity Center Pc 3280 Henderson Dr Ste C Jacksonville NC 28546-5290 Ph: (910) 915-8450 |
| NPI Number | 1518397587 |
|---|---|
| Provider Enumeration Date | 11/12/2013 |
| Last Update Date | 09/12/2022 |
| Medicare PECOS PAC ID | 7719106186 |
|---|---|
| Medicare Enrollment ID | O20140917000470 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518397587 | NPI | - | NPPES |
| Provider Name | Shyamal K Mitra |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1467437079 PECOS PAC ID: 2860478120 Enrollment ID: I20040628000190 |
| Provider Name | Stephanie Marie Place |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366917999 PECOS PAC ID: 8527302074 Enrollment ID: I20181210003283 |
| Provider Name | Michelle L Snyder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053021717 PECOS PAC ID: 4981074424 Enrollment ID: I20221228001277 |
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