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Organization
SHILAND FAMILY MEDICINE
Active
Organization
SHILAND FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL L. WIENS (SENIOR VICE PRESIDENT OF OPERATIONS)
(704) 355-0648
Entity
Organization
Contact information
Practice address
13640 STEELECROFT PKWY, SUITE 320, CHARLOTTE, NC 28278-7565
(803) 329-5131
(803) 366-6600
Mailing address
PO BOX 60114, CHARLOTTE, NC 28260-0114
(803) 329-5131
(803) 366-6600
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NPB357
—
SC
Enumeration date
12/22/2009
Last updated
03/25/2010
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