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1480 Wesley Chapel Rd Indian Trail NC 28079-5244 | |
(704) 316-3616 | |
(704) 316-1199 |
Full Name | |
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Speciality | Family Medicine |
Location | 1480 Wesley Chapel Rd, Indian Trail, 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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Po Box 60447 Charlotte NC 28260-0447 Ph: (704) 384-7840 | 1480 Wesley Chapel Rd Indian Trail NC 28079-5244 Ph: (704) 316-3616 |
NPI Number | 1922046929 |
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Provider Enumeration Date | 06/02/2006 |
Last Update Date | 07/09/2024 |
Identifier | Type | State | Issuer |
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1922046929 | NPI | - | NPPES |
89011AV | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Indian Trail Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4503 Old Monroe Rd, Indian Trail, NC 28079 Phone: 704-821-6900 Fax: 704-821-6911 | |
Imbue Health Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4389 Indian Trail Fairview Rd Ste 7, Indian Trail, NC 28079 Phone: 704-218-9322 Fax: 704-803-8126 | |