| NPI | 1588469548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WASEEM GHANNAM President 704-231-4571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 363LP2300X Nurse Practitioner, Primary Care | |
| 207Q00000X Family Medicine | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LA2100X Nurse Practitioner, Acute Care | |
| 363LG0600X Nurse Practitioner, Gerontology | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| Enumeration Date | 2025-02-14 |
| Last Update Date | 2025-10-04 |