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6050 W Highway 74 Indian Trail NC 28079-3591 | |
(704) 863-4878 | |
Not Available |
Full Name | |
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Speciality | Family Medicine - Sports Medicine |
Location | 6050 W Highway 74, Indian Trail, North Carolina |
Authorized Official Name and Position | Scott Rissmiller (ENTERPRISE EVP) |
Authorized Official Contact | 7043558675 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 19305 Charlotte NC 28219-9305 Ph: (704) 631-0002 | 6050 W Highway 74 Indian Trail NC 28079-3591 Ph: (704) 863-4878 |
NPI Number | 1427309608 |
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Provider Enumeration Date | 09/27/2012 |
Last Update Date | 03/09/2023 |
Identifier | Type | State | Issuer |
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1427309608 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
207RS0010X | Internal Medicine - Sports Medicine | (* (Not Available)) | Secondary |
Indian Trail Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4503 Old Monroe Rd, Indian Trail, NC 28079 Phone: 704-821-6900 Fax: 704-821-6911 | |
Imbue Health Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4389 Indian Trail Fairview Rd Ste 7, Indian Trail, NC 28079 Phone: 704-218-9322 Fax: 704-803-8126 | |