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105 Elm Street Mcadenville NC 28101-0490 | |
(704) 824-5323 | |
(704) 824-5410 |
Full Name | |
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Speciality | Family Medicine |
Location | 105 Elm Street, Mcadenville, North Carolina |
Authorized Official Name and Position | David Michael 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 | 105 Elm Street Mcadenville NC 28101-0490 Ph: (704) 824-5323 |
NPI Number | 1003097023 |
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Provider Enumeration Date | 11/19/2007 |
Last Update Date | 07/13/2023 |
Identifier | Type | State | Issuer |
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1003097023 | NPI | - | NPPES |
890151P | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |