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6030 Hwy 74 Suite D Indian Trail NC 28079-3469 | |
(704) 246-2800 | |
(704) 246-2888 |
Full Name | |
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Speciality | Internal Medicine |
Location | 6030 Hwy 74, Indian Trail, North Carolina |
Authorized Official Name and Position | Daniel L/ Wiens (SENIOR VICE PRESIDENT OPERATIONS) |
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 601885 Charlotte NC 28260-1885 Ph: (704) 246-2800 | 6030 Hwy 74 Suite D Indian Trail NC 28079-3469 Ph: (704) 246-2800 |
NPI Number | 1164747580 |
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Provider Enumeration Date | 03/29/2010 |
Last Update Date | 04/06/2011 |
Identifier | Type | State | Issuer |
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1164747580 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Indian Trail Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4503 Old Monroe Rd, Indian Trail, NC 28079 Phone: 704-821-6900 Fax: 704-821-6911 | |
Imbue Health Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4389 Indian Trail Fairview Rd Ste 7, Indian Trail, NC 28079 Phone: 704-218-9322 Fax: 704-803-8126 | |