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4503 Old Monroe Rd Suite A Indian Trail NC 28079-5309 | |
(704) 684-0003 | |
(704) 684-0041 |
Full Name | |
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Speciality | Internal Medicine - Endocrinology, Diabetes & Metabolism |
Location | 4503 Old Monroe Rd, Indian Trail, North Carolina |
Authorized Official Name and Position | Thomas Ford Laymon (SENIOR VICE PRESIDENT) |
Authorized Official Contact | 7046310002 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 601888 Charlotte NC 28260-1888 Ph: (704) 684-0003 | 4503 Old Monroe Rd Suite A Indian Trail NC 28079-5309 Ph: (704) 684-0003 |
NPI Number | 1447596259 |
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Provider Enumeration Date | 12/26/2012 |
Last Update Date | 08/19/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447596259 | NPI | - | NPPES |
NPB652 | Medicaid | SC | |
5922605 | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
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 | |