Organization
CHARLOTTE MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL L WIENS (SENIOR VICE PRESIDENT)
(704) 355-0648
Entity
Organization
Contact information
Practice address
3025 SPRINGBANK LANE, SUITE 100, CHARLOTTE, NC 28226-3368
(704) 446-2620
(704) 542-2832
Mailing address
PO BOX 601643, CHARLOTTE, NC 28260-1643
(704) 446-2620
(704) 542-2832
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
04/23/2009
Last updated
07/22/2010
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