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CHARLOTTE MEDICAL CLINIC NPI 1083649214


NPI Information

NPI: 1083649214
Provider Name: CHARLOTTE MEDICAL CLINIC
Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
1001 BLYTHE BLVD
MCP SUITE 500
CHARLOTTE, NC
ZIP 28203
Phone: (704) 355-5100
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CHARLOTTE MEDICAL CLINIC is an internal medicine in Charlotte, NC. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. CHARLOTTE MEDICAL CLINIC NPI is 1083649214. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1001 BLYTHE BLVD
MCP SUITE 500
CHARLOTTE, NC
ZIP 28203-874
Phone: (704) 355-5100
Fax: (704) 355-5180

The provider's authorized official is Daniel L Wiens .
The authorized official title is Senior Vice President and has the following contact phone number (704) 355-0648.

The enumeration date for this NPI number is 7/12/2006 and was last updated on 9/9/2008.


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
1208100000XPhysical Medicine & RehabilitationNo
2207RE0101XInternal MedicineEndocrinology, Diabetes & MetabolismNo
3207N00000XDermatologyNo
4207RC0000XInternal MedicineCardiovascular DiseaseNo
5207RG0100XInternal MedicineGastroenterologyNo
6207RP1001XInternal MedicinePulmonary DiseaseNo
7207RR0500XInternal MedicineRheumatologyNo
8207R00000XInternal MedicineYes

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
12308414MEDICARE ID-TYPE UNSPECIFIEDNORTH CAROLINAGROUP NUMBER
289012Y0MEDICAIDNORTH 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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