Indian Trail Family Medicine | |
4503 Old Monroe Rd Indian Trail NC 28079-5309 | |
(704) 821-6900 | |
(704) 821-6911 |
Full Name | Indian Trail Family Medicine |
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Speciality | Family Medicine |
Location | 4503 Old Monroe Rd, Indian Trail, North Carolina |
Authorized Official Name and Position | Daniel L Wiens (SENIOR 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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Indian Trail Family Medicine 5000 Airport Center Pkwy Ste A Charlotte NC 28208-5899 Ph: (704) 512-4116 | Indian Trail Family Medicine 4503 Old Monroe Rd Indian Trail NC 28079-5309 Ph: (704) 821-6900 |
NPI Number | 1003842782 |
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Provider Enumeration Date | 06/24/2006 |
Last Update Date | 02/12/2008 |
Identifier | Type | State | Issuer |
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1003842782 | NPI | - | NPPES |
7901052 | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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 | |