| Shelby Family Practice | |
|
1124 N Washington St Shelby NC 28150-3862 | |
| (980) 487-1148 | |
| (704) 487-7753 |
| Full Name | Shelby Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 1124 N Washington St, Shelby, North Carolina |
| Authorized Official Name and Position | Daniel L. Wiens (SENIOR VICE PRESIDENT OF OPERATIONS) |
| Authorized Official Contact | 7043550648 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shelby Family Practice Po Box 601884 Charlotte NC 28260-1884 Ph: (980) 487-1148 | Shelby Family Practice 1124 N Washington St Shelby NC 28150-3862 Ph: (980) 487-1148 |
| NPI Number | 1649345935 |
|---|---|
| Provider Enumeration Date | 11/21/2006 |
| Last Update Date | 07/12/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649345935 | NPI | - | NPPES |
| 5905818 | Medicaid | NC | |
| NPB304 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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