# PREMISE HEALTH OF NORTH CAROLINA MEDICAL, P.C

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- **Entity:** Organization
- **Status:** Active
- **Other names:** TIAA-CREF-Charlotte
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639473499
- **Authorized official:** JON LEIZMAN MD (PRESIDENT)
- **Authorized official phone:** (216) 479-9063

## Contact information

- **Practice address:** 8500 ANDREW CARNEGIE BLVD, MS D1/01, CHARLOTTE, NC 28262-8500
- **Practice address phone:** (704) 988-2572
- **Practice address fax:** (704) 988-4820
- **Mailing address:** 5500 MARYLAND WAY STE 120, BRENTWOOD, TN 37027-4993

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/07/2011
- **Last updated:** 08/24/2022