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8420 University Exec Park Dr Suite 850 Charlotte NC 28262-1344 | |
| (704) 316-1750 | |
| (704) 316-1755 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 8420 University Exec Park Dr, Charlotte, North Carolina |
| Authorized Official Name and Position | Geoffrey K. Gardner (VP OF FINANCE) |
| Authorized Official Contact | 7043849144 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 60447 Charlotte NC 28260-0447 Ph: (704) 384-7840 | 8420 University Exec Park Dr Suite 850 Charlotte NC 28262-1344 Ph: (704) 316-1750 |
| NPI Number | 1396784104 |
|---|---|
| Provider Enumeration Date | 06/06/2006 |
| Last Update Date | 11/22/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396784104 | NPI | - | NPPES |
| 0109P | Other | NC | BCBS-NC |
| CC5118 | Other | NC | RAILROAD MEDICARE |
| 89015FJ | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (North Carolina) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
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 | |
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 |