Individual
DR. JOHN C VICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1106 REYNOLDS ST, SUITE 100, MONROE, NC 28112-4376
(704) 289-5443
(704) 283-7655
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
(704) 289-5443
(704) 283-7655
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21888
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
85081
BCBS
NC
05
—
8985081
—
NC
05
—
N21888
—
SC
Enumeration date
07/18/2006
Last updated
08/05/2019
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