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MOUNTAIN ISLAND FAMILY MEDICINE PC NPI 1669664264


NPI Information

NPI: 1669664264
Provider Name: MOUNTAIN ISLAND FAMILY MEDICINE, PC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
10226 COULOAK DR
SUITE 110
CHARLOTTE, NC
ZIP 28216
Phone: (704) 399-1415
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MOUNTAIN ISLAND FAMILY MEDICINE, PC is a primary care clinic center in Charlotte, NC. MOUNTAIN ISLAND FAMILY MEDICINE, PC NPI is 1669664264. The provider is registered as an organization entity type.

The provider's business location address is:

10226 COULOAK DR
SUITE 110
CHARLOTTE, NC
ZIP 28216-675
Phone: (704) 399-1415
Fax: (704) 399-1415

The provider's authorized official is Clayton R Bailey .
The authorized official title is President and has the following contact phone number (704) 399-1415.

The enumeration date for this NPI number is 8/16/2007 and was last updated on 2/2/2011.


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
1261QP2300XClinic/CenterPrimary Care125435NORTH 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
12347033MEDICARE PINNORTH 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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.