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Organization
UNION FAMILY PRACTICE
Active
Organization
UNION FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL L WIENS (SENIOR VICE PRESIDENT)
(704) 355-0648
Entity
Organization
Contact information
Practice address
1106 REYNOLDS STREET, SUITE 100, MONROE, NC 28112-4376
(704) 289-5443
(704) 283-7655
Mailing address
PO BOX 601888, CHARLOTTE, NC 28260-1888
(704) 289-5443
(704) 283-7655
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5905686
—
NC
05
—
NPB206
—
SC
Enumeration date
06/26/2006
Last updated
05/17/2013
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