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9606 Caldwell Commons Cir Ste B Cornelius NC 28031-8111 | |
(704) 892-3213 | |
(704) 892-3966 |
Full Name | |
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Speciality | Family Medicine |
Location | 9606 Caldwell Commons Cir, Cornelius, North Carolina |
Authorized Official Name and Position | Daniel L. Wiens (SR. VICE PRESIDENT) |
Authorized Official Contact | 7043550648 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 602095 Charlotte NC 28260-2095 Ph: (704) 892-3213 | 9606 Caldwell Commons Cir Ste B Cornelius NC 28031-8111 Ph: (704) 892-3213 |
NPI Number | 1154587103 |
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Provider Enumeration Date | 07/30/2008 |
Last Update Date | 10/14/2008 |
Identifier | Type | State | Issuer |
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1154587103 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Diabetic Special Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 19900 W Catawba Ave, Cornelius, NC 28031 Phone: 704-895-8478 Fax: 704-895-8478 | |
Innovative Healthcare Management Provider Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 19401 Old Jetton Rd Ste 100, Cornelius, NC 28031 Phone: 704-473-5263 Fax: 704-731-0961 | |