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Organization
SOUTHEAST FAMILY CARE PLLC
Active
Organization
SOUTHEAST FAMILY CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HIRENKUMAR D ITALIA MD (PRESIDENT/PHYSICIAN)
(704) 512-9921
Entity
Organization
Contact information
Practice address
10035 PARK CEDAR DR STE 100, CHARLOTTE, NC 28210-8910
(704) 544-2524
(704) 544-2647
Mailing address
3041 DANIEL PLACE DR, CHARLOTTE, NC 28213
(704) 544-2524
(704) 544-2647
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2013-01926
NC
Other
Enumeration date
08/18/2017
Last updated
08/18/2017
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