# DIABETES ENDOCRINOLOGY & METABOLISM ASSOCIATES, PA

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

## Provider details

- **NPI number:** 1710064233
- **Authorized official:** DR. GODWIN OBINNA UZOMBA M.D. (PRESIDENT)
- **Authorized official phone:** (704) 540-9181

## Contact information

- **Practice address:** 115 STONE VILLAGE DR, FORT MILL, SC 29708-6489
- **Practice address phone:** (704) 540-9181
- **Mailing address:** PO BOX 471947, CHARLOTTE, NC 28247-1947
- **Mailing address phone:** (704) 540-9181
- **Mailing address fax:** (704) 540-9182

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | Yes |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/01/2006
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 014KK | BC/BS OF NORTH CAROLINA | NC |
| 01 | — | 1710064233 | GROUP NPI | NC |
| 01 | — | 1710064233 | GROUP NPI | SC |
| 05 | — | 89014KK | — | NC |
| 05 | — | 891277F | — | NC |
| 05 | — | GP1763 | — | SC |
| 05 | — | GP3653 | — | SC |