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1106 Reynolds St Suite 100 Monroe NC 28112-4350 | |
(704) 289-5443 | |
(704) 283-7655 |
Full Name | |
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Speciality | Family Medicine |
Location | 1106 Reynolds St, Monroe, 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 |
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P O Box 601888 Charlotte NC 28260-0628 Ph: (704) 289-5443 | 1106 Reynolds St Suite 100 Monroe NC 28112-4350 Ph: (704) 289-5443 |
NPI Number | 1962578682 |
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Provider Enumeration Date | 11/27/2006 |
Last Update Date | 08/19/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1962578682 | NPI | - | NPPES |
5905686 | Medicaid | NC | |
7705117 | Medicaid | NC | |
018P6 | Other | NC | BCBS |
NPB206 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
332B00000X | Durable Medical Equipment & Medical Supplies | (North Carolina) | Secondary |
Circle Medical Associates Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1111 Circle Dr, Monroe, NC 28112 Phone: 704-289-8537 Fax: 704-283-4602 | |