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Organization
SCOTLAND REGIONAL HEALTH NETWORK
Active
Organization
SCOTLAND REGIONAL HEALTH NETWORK
Active
Parent organization
SCOTLAND REGIONAL HEALTH NETWORK
Other names
Wagram Family Practice
Organization subpart
Yes
Provider details
NPI number
Legal business name
SCOTLAND REGIONAL HEALTH NETWORK
Authorized official
MATHEW DAVID PRACHT (TREASURER)
(910) 291-7920
Entity
Organization
Contact information
Practice address
24420 MARLBORO STREET, WAGRAM, NC 28396-9600
(919) 369-3136
(910) 369-4756
Mailing address
PO BOX 602458, CHARLOTTE, NC 28260-2458
(910) 369-3136
(910) 369-4756
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982913422
—
NC
05
—
5916876
—
NC
05
—
NPB433
—
SC
Enumeration date
10/01/2010
Last updated
01/11/2017
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