| Internal Medicine Specialist, Pa | |
|
3101 Latrobe Dr Charlotte NC 28211-4849 | |
| (704) 376-7362 | |
| Not Available |
| Full Name | Internal Medicine Specialist, Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 3101 Latrobe Dr, Charlotte, North Carolina |
| Authorized Official Name and Position | Michael Frye (TREASURER) |
| Authorized Official Contact | 7043767362 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine Specialist, Pa 3101 Latrobe Dr Charlotte NC 28211-4849 Ph: (704) 376-7362 | Internal Medicine Specialist, Pa 3101 Latrobe Dr Charlotte NC 28211-4849 Ph: (704) 376-7362 |
| NPI Number | 1326079567 |
|---|---|
| Provider Enumeration Date | 07/05/2006 |
| Last Update Date | 01/15/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326079567 | NPI | - | NPPES |
| 8901076 | Medicaid | NC | |
| NPB152 | Medicaid | SC | |
| 89013WK | Medicaid | NC | |
| NPB153 | Medicaid | SC | |
| NPB154 | Medicaid | SC | |
| 89013WJ | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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