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Organization
STATESVILLE HMA MEDICAL GROUP LLC
Active
Organization
STATESVILLE HMA MEDICAL GROUP LLC
Active
Parent organization
STATESVILLE HMA MEDICAL GROUP LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATESVILLE HMA MEDICAL GROUP LLC
Authorized official
SANDRA BALES (CREDENTIALING COORDINATOR)
(704) 660-4524
Entity
Organization
Contact information
Practice address
1102 YADKINVILLE RD STE A-B, MOCKSVILLE, NC 27028-2037
(704) 660-4693
Mailing address
131 MEDICAL PARK RD STE 302, MOORESVILLE, NC 28117-8525
(704) 660-4524
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
04/11/2022
Last updated
04/11/2022
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