| |
600 W Trade St Ste A Dallas NC 28034-1543 | |
(980) 834-9130 | |
(980) 834-9135 |
Full Name | |
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Speciality | Family Medicine |
Location | 600 W Trade St Ste A, Dallas, North Carolina |
Authorized Official Name and Position | David M Oconnor (CFO) |
Authorized Official Contact | 7046715343 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 744786 Atlanta GA 30374-4786 Ph: (704) 834-2450 | 600 W Trade St Ste A Dallas NC 28034-1543 Ph: (980) 834-9130 |
NPI Number | 1114420254 |
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Provider Enumeration Date | 03/15/2018 |
Last Update Date | 04/20/2023 |
Identifier | Type | State | Issuer |
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1114420254 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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