Novant Health Lakeside Primary Care | |
5325 Vinning St Nw Suite 101 Concord NC 28027-2956 | |
(704) 316-1040 | |
(704) 316-1041 |
Full Name | Novant Health Lakeside Primary Care |
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Speciality | Family Medicine |
Location | 5325 Vinning St Nw, Concord, North Carolina |
Authorized Official Name and Position | Leea Jeanine Walton (RCS MANAGER) |
Authorized Official Contact | 7043166081 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Novant Health Lakeside Primary Care Po Box 60447 Charlotte NC 28260-0447 Ph: (704) 316-1040 | Novant Health Lakeside Primary Care 5325 Vinning St Nw Suite 101 Concord NC 28027-2956 Ph: (704) 316-1040 |
NPI Number | 1093976474 |
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Provider Enumeration Date | 06/19/2008 |
Last Update Date | 07/09/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1093976474 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (North Carolina) | Primary |
207R00000X | Internal Medicine | (North Carolina) | Secondary |
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