| Freedom Medical Clinic & Urgent Care Pa | |
|
2905 Freedom Drive Charlotte NC 28208-3857 | |
| (704) 394-3033 | |
| (704) 394-3395 |
| Full Name | Freedom Medical Clinic & Urgent Care Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 2905 Freedom Drive, Charlotte, North Carolina |
| Authorized Official Name and Position | Ndofunsu Badika (OWNER) |
| Authorized Official Contact | 7043943033 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Freedom Medical Clinic & Urgent Care Pa 2905 Freedom Drive Charlotte NC 28208-3857 Ph: (704) 394-3033 | Freedom Medical Clinic & Urgent Care Pa 2905 Freedom Drive Charlotte NC 28208-3857 Ph: (704) 394-3033 |
| NPI Number | 1255450235 |
|---|---|
| Provider Enumeration Date | 03/28/2007 |
| Last Update Date | 07/14/2014 |
| Medicare PECOS PAC ID | 1052347341 |
|---|---|
| Medicare Enrollment ID | O20050708000390 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255450235 | NPI | - | NPPES |
| 2346988 | Other | NC | MEDIARE PTAN |
| 5901934 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Ndofunsu Mabeka Badika |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114915758 PECOS PAC ID: 8426067687 Enrollment ID: I20060417000323 |
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