MECKLENBURG MEDICAL GROUP

CHARLOTTE, NC
NPI1255364535
Entity TypeOrganization
Authorized ContactDANIEL L WIENS
Senior Vice President
704-355-0648
Organization Subpart ?No
Primary Taxonomy207R00000X Internal Medicine
Additional Taxonomies207N00000X Dermatology
207RC0000X Internal Medicine, Cardiovascular Disease
207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism
207RG0100X Internal Medicine, Gastroenterology
207RH0003X Internal Medicine, Hematology & Oncology
207RI0200X Internal Medicine, Infectious Disease
207RP1001X Internal Medicine, Pulmonary Disease
207RR0500X Internal Medicine, Rheumatology
Enumeration Date2006-07-09
Last Update Date2013-03-06
Business Address
MECKLENBURG MEDICAL GROUP
7903 PROVIDENCE RD SUITE 100
CHARLOTTE, NC 28277-9720
Phone number: 704-367-8610
Mailing Address
MECKLENBURG MEDICAL GROUP
PO BOX 601643
CHARLOTTE, NC 28260-1643
Phone number: 704-367-8610