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2700 Providence Road South Suite 300 Waxhaw NC 28173 | |
| (704) 243-2254 | |
| (704) 243-2339 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 2700 Providence Road South, Waxhaw, 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 |
|---|---|
Po Box 601215 Charlotte NC 28260-1215 Ph: (704) 243-2254 | 2700 Providence Road South Suite 300 Waxhaw NC 28173 Ph: (704) 243-2254 |
| NPI Number | 1922017391 |
|---|---|
| Provider Enumeration Date | 08/05/2006 |
| Last Update Date | 12/02/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922017391 | NPI | - | NPPES |
| 89012UN | Medicaid | NC | |
| 012UN | Other | NC | BLUE CROSS - BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Gaston Family Health Services, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2700 Providence Rd S Ste 200, Waxhaw, NC 28173 Phone: 704-289-2553 | |
Ratliff Integrative Medicine, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 104 Waxhaw Professional Park Dr Ste D, Waxhaw, NC 28173 Phone: 704-560-5508 | |
Peace Medical Center And Wellness, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9605 Gato Del Sol Ct, Waxhaw, NC 28173 Phone: 980-315-3540 | |
Charlotte Medical Clinic Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2700 Providence Rd S, Suite 320, Waxhaw, NC 28173 Phone: 704-667-6750 Fax: 704-667-6751 |