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14035 Grandiflora Drive Ste B Charlotte NC 28278-8456 | |
| (704) 583-1155 | |
| (704) 504-2495 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 14035 Grandiflora Drive, Charlotte, North Carolina |
| Authorized Official Name and Position | Craig A Dunker (VP PRACTICE MANAGEMENT) |
| Authorized Official Contact | 7048342135 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
14035 Grandiflora Drive Ste B Charlotte NC 28278-8456 Ph: (704) 583-1155 | 14035 Grandiflora Drive Ste B Charlotte NC 28278-8456 Ph: (704) 583-1155 |
| NPI Number | 1407035025 |
|---|---|
| Provider Enumeration Date | 10/31/2007 |
| Last Update Date | 12/06/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407035025 | NPI | - | NPPES |
| 5906334 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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