# CALVARY COMMUNITY MEDICAL

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

## Provider details

- **NPI number:** 1972905644
- **Authorized official:** OKYERE BONNA (ADMINISTRATOR)
- **Authorized official phone:** (704) 526-9052

## Contact information

- **Practice address:** 537 W SUGAR CREEK RD, SUITE 201, CHARLOTTE, NC 28213-6102
- **Practice address phone:** (704) 979-8210
- **Practice address fax:** (187) 749-2888
- **Mailing address:** 16725 WINSTON OAKS CT, CHARLOTTE, NC 28213-5206
- **Mailing address phone:** (704) 534-1035

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2300X | Primary Care Clinic/Center | 5007063 | NC | Yes |

## Other

- **Enumeration date:** 09/24/2014
- **Last updated:** 09/24/2014