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MID-ATLANTIC EMERGENCY MEDICAL ASSOCIATES PLLC NPI 1073562757


NPI Information

NPI: 1073562757
Provider Name: MID-ATLANTIC EMERGENCY MEDICAL ASSOCIATES, PLLC
Classification: Emergency Medicine - 207P00000X
Entity Type: Organization
Address:
501 S SHARON AMITY RD STE 300
CHARLOTTE, NC
ZIP 28211
Phone: (704) 377-2424
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MID-ATLANTIC EMERGENCY MEDICAL ASSOCIATES, PLLC is an emergency medicine in Charlotte, NC. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. MID-ATLANTIC EMERGENCY MEDICAL ASSOCIATES, PLLC NPI is 1073562757. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

501 S SHARON AMITY RD STE 300
CHARLOTTE, NC
ZIP 28211
Phone: (704) 377-2424
Fax: (704) 377-2687

The provider's authorized official is Michael Wayne Icenhour .
The authorized official title is Chief Operating Officer and has the following contact phone number (704) 319-5822.

The enumeration date for this NPI number is 5/9/2006 and was last updated on 7/3/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207P00000XEmergency MedicineNORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1QPA373MEDICAIDSOUTH CAROLINA
289-0294WMEDICAIDNORTH CAROLINA
389-0295HMEDICAIDNORTH CAROLINA
40294WOTHERNORTH CAROLINABCBSNC
589-0295GMEDICAIDNORTH CAROLINA
689-01401MEDICAIDNORTH CAROLINA
7NPA822MEDICAIDSOUTH CAROLINA
8CI1307OTHERNORTH CAROLINARR MEDICARE
9NPA807MEDICAIDSOUTH CAROLINA
10QPA372MEDICAIDSOUTH CAROLINA
1189-016RMMEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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