# NORTH MECKLENBURG FAMILY PRACTICE GROUP PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225139660
- **Authorized official:** JEROME HOWARD MD (MD PRESIDENT)
- **Authorized official phone:** (704) 596-5067

## Contact information

- **Practice address:** 6111 RUMPLE RD, CHARLOTTE, NC 28262
- **Practice address phone:** (704) 596-5067
- **Practice address fax:** (704) 599-9458
- **Mailing address:** 6111 RUMPLE RD, CHARLOTTE, NC 28262
- **Mailing address phone:** (704) 596-5067
- **Mailing address fax:** (704) 599-9458

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | NC18523 | NC | Yes |

## Other

- **Enumeration date:** 09/26/2006
- **Last updated:** 07/09/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 44170 | BCBS | NC |