| Eastowne Family Physicians, P.a | |
|
4115 The Plz Charlotte NC 28205-1356 | |
| (704) 532-4567 | |
| (704) 532-4580 |
| Full Name | Eastowne Family Physicians, P.a |
|---|---|
| Speciality | Family Medicine |
| Location | 4115 The Plz, Charlotte, North Carolina |
| Authorized Official Name and Position | Tagbo Ekwonu (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7045324567 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastowne Family Physicians, P.a Po Box 1280 Matthews NC 28106-1280 Ph: (704) 532-4567 | Eastowne Family Physicians, P.a 4115 The Plz Charlotte NC 28205-1356 Ph: (704) 532-4567 |
| NPI Number | 1154518678 |
|---|---|
| Provider Enumeration Date | 09/28/2007 |
| Last Update Date | 03/30/2022 |
| Medicare PECOS PAC ID | 4385734425 |
|---|---|
| Medicare Enrollment ID | O20071213000306 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154518678 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Tagbo Ekwonu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093890535 PECOS PAC ID: 6305936444 Enrollment ID: I20071213000292 |
| Provider Name | Laura Gregory |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033722970 PECOS PAC ID: 0648680249 Enrollment ID: I20201111000637 |
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