| Prime Health Medical Clinic, Pa | |
|
1400 Medford Dr Charlotte NC 28205-5624 | |
| (704) 940-5588 | |
| (704) 940-5589 |
| Full Name | Prime Health Medical Clinic, Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1400 Medford Dr, Charlotte, North Carolina |
| Authorized Official Name and Position | Sylvester I Ogbata (OWNER) |
| Authorized Official Contact | 2035459119 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Health Medical Clinic, Pa 7619 Berryfield Ct Waxhaw NC 28173-9817 Ph: (203) 545-9119 | Prime Health Medical Clinic, Pa 1400 Medford Dr Charlotte NC 28205-5624 Ph: (704) 940-5588 |
| NPI Number | 1063781094 |
|---|---|
| Provider Enumeration Date | 12/20/2011 |
| Last Update Date | 09/23/2021 |
| Medicare PECOS PAC ID | 4688814585 |
|---|---|
| Medicare Enrollment ID | O20130716000800 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063781094 | NPI | - | NPPES |
| Provider Name | Sylvester Izuchukwu Ogbata |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1346209707 PECOS PAC ID: 3173563202 Enrollment ID: I20050509000732 |
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