| Metrolina Internal Medicine Pa | |
|
2300 Randolph Rd Ste A Charlotte NC 28207-1586 | |
| (704) 372-9393 | |
| (704) 372-0135 |
| Full Name | Metrolina Internal Medicine Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 2300 Randolph Rd Ste A, Charlotte, North Carolina |
| Authorized Official Name and Position | Clarence O'neil Ellis (PRESIDENT) |
| Authorized Official Contact | 7043729393 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Metrolina Internal Medicine Pa 2300 Randolph Rd Ste A Charlotte NC 28207-1586 Ph: (704) 372-9393 | Metrolina Internal Medicine Pa 2300 Randolph Rd Ste A Charlotte NC 28207-1586 Ph: (704) 372-9393 |
| NPI Number | 1326000845 |
|---|---|
| Provider Enumeration Date | 04/03/2006 |
| Last Update Date | 04/03/2018 |
| Medicare PECOS PAC ID | 8729971379 |
|---|---|
| Medicare Enrollment ID | O20040207000255 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326000845 | NPI | - | NPPES |
| 790278J | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 83588 (North Carolina) | Primary |
| Provider Name | Karlton Shea Pettis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871555375 PECOS PAC ID: 0143208447 Enrollment ID: I20040713000257 |
| Provider Name | Clarence O Neil Ellis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376505305 PECOS PAC ID: 7719870146 Enrollment ID: I20110817000525 |
| Provider Name | Tyesha R Harvey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609360239 PECOS PAC ID: 5991059586 Enrollment ID: I20181119000429 |
| Provider Name | Felicia Harrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497130306 PECOS PAC ID: 6002125101 Enrollment ID: I20181228000547 |
Novant Health Infectious Disease Specialists Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1900 Randolph Rd, Suite 216, Charlotte, NC 28207 Phone: 704-384-5416 Fax: 704-384-5996 | |
Atrium Health Infectious Disease Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10660 Park Rd, Ste 4400, Charlotte, NC 28210 Phone: 704-355-0607 | |
Amity Medical Group, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6010 E W T Harris Blvd, Charlotte, NC 28215 Phone: 704-208-4134 Fax: 704-248-8068 | |
Companion Health, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5029 Lady Fern Cir, Charlotte, NC 28211 Phone: 704-236-2658 | |
Novant Health Carolina Family Physicians Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7110 Lawyers Rd, Charlotte, NC 28227 Phone: 704-537-0020 Fax: 704-316-8634 | |
Kent Seitz Md Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1421 Orchard Lake Drive, Suite C, Charlotte, NC 28270 Phone: 704-844-0181 Fax: 904-701-6279 | |
Health And Wellness Services Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 715 E 5th St, Suite 214, Charlotte, NC 28202 Phone: 704-909-7954 |