| Mecklenburg Medical Group | |
|
7666 Charlotte Highway Suite 200 Indian Land SC 29707-7001 | |
| (704) 302-9600 | |
| (803) 431-8225 |
| Full Name | Mecklenburg Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 7666 Charlotte Highway, Indian Land, South Carolina |
| Authorized Official Name and Position | Daniel L Wiens (SENIOR VICE PRESIDENT OPERATIONS) |
| Authorized Official Contact | 7043550648 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mecklenburg Medical Group Po Box 60063 Charlotte NC 28260-0063 Ph: (704) 302-9600 | Mecklenburg Medical Group 7666 Charlotte Highway Suite 200 Indian Land SC 29707-7001 Ph: (704) 302-9600 |
| NPI Number | 1518282581 |
|---|---|
| Provider Enumeration Date | 04/02/2010 |
| Last Update Date | 04/02/2010 |
| Medicare PECOS PAC ID | 9931196797 |
|---|---|
| Medicare Enrollment ID | O20090629000513 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518282581 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | George A Butler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770580193 PECOS PAC ID: 3870508930 Enrollment ID: I20060209000664 |
| Provider Name | Gregory R Kimmerle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669574604 PECOS PAC ID: 8426083890 Enrollment ID: I20100504000237 |
| Provider Name | Daniel E Haggstrom |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1891958013 PECOS PAC ID: 8921152190 Enrollment ID: I20110906000323 |
| Provider Name | Kedist Tedla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063451078 PECOS PAC ID: 3577530435 Enrollment ID: I20130703000163 |
| Provider Name | Tracela C Vaden |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588698229 PECOS PAC ID: 3173543188 Enrollment ID: I20150910001813 |
| Provider Name | Seth P Vining |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477991479 PECOS PAC ID: 6608198015 Enrollment ID: I20160804001734 |
| Provider Name | Olga Decker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538366711 PECOS PAC ID: 1456445436 Enrollment ID: I20180926000160 |
| Provider Name | Kashiti G Long |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720498686 PECOS PAC ID: 2163762196 Enrollment ID: I20190328002447 |
| Provider Name | Vinutha Chowdary Muppuri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467694125 PECOS PAC ID: 6305012329 Enrollment ID: I20191030001218 |
| Provider Name | Surbhi Jain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982054730 PECOS PAC ID: 5698105344 Enrollment ID: I20200420002246 |
Novant Health Indian Land Primary Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6237 Carolina Commons Dr, Suite 101, Indian Land, SC 29707 Phone: 803-548-9393 Fax: 803-548-9590 | |
Kds Consultants, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8351 Charlotte Hwy Ste 200, Indian Land, SC 29707 Phone: 803-285-1082 Fax: 803-283-4329 | |
Palmetto Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1040 Edgewater Corporate Pkwy Suite 101, Indian Land, SC 29707 Phone: 803-548-7007 | |
Levine Cancer Institute Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7666 Charlotte Hwy, Suite 200-a, Indian Land, SC 29707 Phone: 704-302-9600 Fax: 704-302-9601 | |
Barnett Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7666 Charlotte Hwy, Ste 120, Indian Land, SC 29707 Phone: 803-431-8220 | |
Mackey Family Practice, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8351 Charlotte Hwy, Suite 200, Indian Land, SC 29707 Phone: 803-396-5368 Fax: 803-396-5350 |