PRIME HEALTH MEDICAL CLINIC PA NPI 1063781094

NPI Information

  • NPI: 1063781094
  • Provider Name: PRIME HEALTH MEDICAL CLINIC, PA
  • Classification: Internal Medicine - 207RN0300X
  • Specialization: Nephrology
  • Entity Type: Organization
  • CLIA Number: 34D2286183
  • Address: 1400 MEDFORD DR
    CHARLOTTE, NC
    ZIP 28205
  • Phone: (704) 940-5588

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NPI Details

PRIME HEALTH MEDICAL CLINIC, PA is a nephrology internal medicine in Charlotte, NC. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. PRIME HEALTH MEDICAL CLINIC, PA NPI is 1063781094. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1400 MEDFORD DR
CHARLOTTE, NC
ZIP 28205-624
Phone: (704) 940-5588
Fax: (704) 940-5589

The provider's authorized official is Sylvester I Ogbata .
The authorized official title is Owner and has the following contact phone number (203) 545-9119.

The CLIA number assigned to this NPI record is 34D2286183 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/20/2011 and was last updated on 9/23/2021.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal MedicineNo
2207RH0002XInternal MedicineHospice and Palliative MedicineNo
3207RN0300XInternal MedicineNephrologyYes

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: 3/30/2025

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