| Shelby Family Practice | |
|
708 Mcbrayer Homestead Rd Shelby NC 28152-9532 | |
| (704) 434-8123 | |
| (704) 434-9919 |
| Full Name | Shelby Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 708 Mcbrayer Homestead Rd, Shelby, North Carolina |
| Authorized Official Name and Position | Daniel L. Wiens (SENIOR VICE PRESIDENT) |
| 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: (704) 434-8123 | Shelby Family Practice 708 Mcbrayer Homestead Rd Shelby NC 28152-9532 Ph: (704) 434-8123 |
| NPI Number | 1841526712 |
|---|---|
| Provider Enumeration Date | 10/27/2009 |
| Last Update Date | 06/18/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841526712 | NPI | - | NPPES |
| 5906847 | Medicaid | NC | |
| NPB305 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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