Organization
CAROLINAS PHYSICIANS NETWORK INC
Active
Other names
Pageland Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL L WIENS (ADMINISTRATOR)
(704) 355-0648
Entity
Organization
Contact information
Practice address
301 NORTH VAN LINGLE MUNGO BLVD., PAGELAND, SC 29728-2319
(843) 672-6127
(843) 672-5748
Mailing address
PO BOX 601888, CHARLOTTE, NC 28260-1888
(843) 672-6127
(843) 672-5748
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42-3846
RURAL HEALTH CLINIC
SC
Enumeration date
12/17/2009
Last updated
03/25/2015
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