Nicole Graham | |
1401 W Innes St Salisbury NC 28144-2574 | |
(704) 636-5626 | |
(704) 636-5641 |
Full Name | Nicole Graham |
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Speciality | Clinic/center - Primary Care |
Location | 1401 W Innes St, Salisbury, North Carolina |
Authorized Official Name and Position | Chetan Amin (OFFICE MANAGER/OWNER) |
Authorized Official Contact | 7046365626 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Nicole Graham 1401 W Innes St Salisbury NC 28144-2574 Ph: (704) 636-5626 | Nicole Graham 1401 W Innes St Salisbury NC 28144-2574 Ph: (704) 636-5626 |
NPI Number | 1225576242 |
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Provider Enumeration Date | 02/09/2017 |
Last Update Date | 02/10/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1225576242 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 0010-07063 (North Carolina) | Primary |
314000000X | Skilled Nursing Facility | 0010-07063 (North Carolina) | Secondary |
Copperfield Medical Center, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 611 Mocksville Ave, Salisbury, NC 28144 Phone: 704-633-7220 Fax: 704-647-0515 | |