Carolina Stem Cell Institute Llc | |
1720 Abbey Pl Charlotte NC 28209-3736 | |
(704) 200-9761 | |
Not Available |
Full Name | Carolina Stem Cell Institute Llc |
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Speciality | Family Medicine |
Location | 1720 Abbey Pl, Charlotte, North Carolina |
Authorized Official Name and Position | Steven R Puckett (MANAGER) |
Authorized Official Contact | 7042009761 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Carolina Stem Cell Institute Llc 1720 Abbey Pl Charlotte NC 28209-3736 Ph: (704) 200-9761 | Carolina Stem Cell Institute Llc 1720 Abbey Pl Charlotte NC 28209-3736 Ph: (704) 200-9761 |
NPI Number | 1578222600 |
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Provider Enumeration Date | 12/16/2021 |
Last Update Date | 12/16/2021 |
Medicare PECOS PAC ID | 9436545233 |
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Medicare Enrollment ID | O20220404001924 |
Identifier | Type | State | Issuer |
---|---|---|---|
1578222600 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | James P. Johnston |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1922095264 PECOS PAC ID: 7315953320 Enrollment ID: I20180926003744 |
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