Provider Type Icon

MEDICAL PLAZA FAMILY & GERIATRIC PHYSICIANS PA NPI 1851630172


NPI Information

NPI: 1851630172
Provider Name: MEDICAL PLAZA FAMILY & GERIATRIC PHYSICIANS, PA
Classification: Family Medicine - 207QG0300X
Entity Type: Organization

Specialization: Geriatric Medicine

CLIA Number: 34D0989989

Address:
8401 MEDICAL PLAZA DR
SUITE 365
CHARLOTTE, NC
ZIP 28262
Phone: (704) 944-0975
Get Directions

MEDICAL PLAZA FAMILY & GERIATRIC PHYSICIANS, PA is a geriatric medicine family medicine in Charlotte, NC. The provider is a family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. MEDICAL PLAZA FAMILY & GERIATRIC PHYSICIANS, PA NPI is 1851630172. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

8401 MEDICAL PLAZA DR
SUITE 365
CHARLOTTE, NC
ZIP 28262-797
Phone: (704) 944-0975
Fax: (704) 943-0699

The provider's authorized official is William J Long .
The authorized official title is Physician/owner and has the following contact phone number (704) 944-0975.

The CLIA number assigned to this NPI record is 34D0989989 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/6/2013 and was last updated on 4/27/2023.


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
1207QG0300XFamily MedicineGeriatric Medicine189833NORTH 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
15922886MEDICAIDNORTH 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

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.