| Park Road Medical Clinic | |
|
1700 Abbey Pl Ste 200 Park Road Medical Clinic Charlotte NC 28209-3742 | |
| (704) 523-2565 | |
| (704) 344-1241 |
| Full Name | Park Road Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 1700 Abbey Pl, Charlotte, North Carolina |
| Authorized Official Name and Position | George L Raad (OWNER) |
| Authorized Official Contact | 7045232565 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Road Medical Clinic Po Box 66 White Sulphur Springs WV 24986-0066 Ph: (304) 536-5030 | Park Road Medical Clinic 1700 Abbey Pl Ste 200 Park Road Medical Clinic Charlotte NC 28209-3742 Ph: (704) 523-2565 |
| NPI Number | 1508811530 |
|---|---|
| Provider Enumeration Date | 05/25/2006 |
| Last Update Date | 08/23/2019 |
| Medicare PECOS PAC ID | 5799791190 |
|---|---|
| Medicare Enrollment ID | O20060331000101 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508811530 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 27283 (North Carolina) | Primary |
| Provider Name | George L Raad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679513998 PECOS PAC ID: 3779599170 Enrollment ID: I20110523000839 |
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