| Signature Healthcare Pllc | |
|
6115 Park South Dr Suite 100 Charlotte NC 28210-3269 | |
| (704) 554-8787 | |
| (704) 554-8774 |
| Full Name | Signature Healthcare Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6115 Park South Dr, Charlotte, North Carolina |
| Authorized Official Name and Position | Jeannette K Anselmo (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7045548787 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Signature Healthcare Pllc 6115 Park South Dr Suite 100 Charlotte NC 28210-3269 Ph: (704) 554-8787 | Signature Healthcare Pllc 6115 Park South Dr Suite 100 Charlotte NC 28210-3269 Ph: (704) 554-8787 |
| NPI Number | 1588602411 |
|---|---|
| Provider Enumeration Date | 06/03/2006 |
| Last Update Date | 09/21/2010 |
| Medicare PECOS PAC ID | 3476678053 |
|---|---|
| Medicare Enrollment ID | O20100920000785 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588602411 | NPI | - | NPPES |
| 014HN | Other | NC | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael Warren Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003830530 PECOS PAC ID: 4688564297 Enrollment ID: I20040317001246 |
| Provider Name | Jordan D Lipton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831158856 PECOS PAC ID: 9739155755 Enrollment ID: I20040909000950 |
| Provider Name | Marshall A Silverman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669435749 PECOS PAC ID: 7416847835 Enrollment ID: I20040927000876 |
| Provider Name | Elizabeth I Abernathy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871518910 PECOS PAC ID: 7517928427 Enrollment ID: I20041025000195 |
| Provider Name | Mary K Hamid |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588635569 PECOS PAC ID: 2466497979 Enrollment ID: I20050624000839 |
| Provider Name | Ameesha P Kansupada |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1700895380 PECOS PAC ID: 4880690270 Enrollment ID: I20061006000439 |
| Provider Name | Michael J Martin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528040623 PECOS PAC ID: 5193850279 Enrollment ID: I20100315000431 |
| Provider Name | David L Yancey |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1477717379 PECOS PAC ID: 9436274495 Enrollment ID: I20100914000637 |
| Provider Name | Elizabeth M Perry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932168937 PECOS PAC ID: 7012033574 Enrollment ID: I20100927000523 |
| Provider Name | Debra J Gazzuolo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548253347 PECOS PAC ID: 7517016314 Enrollment ID: I20140304000396 |
| Provider Name | Andres Felipe Sanchez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982052528 PECOS PAC ID: 7214221035 Enrollment ID: I20190910003300 |
| Provider Name | Tammy Weitzman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720357460 PECOS PAC ID: 5193979557 Enrollment ID: I20220818001894 |
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