Organization
PEDIATRIC ENDOCRINOLOGY & DIABETES SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL L WIENS (SENIOR VICE PRESIDENT OF OPERATIONS)
(704) 355-0648
Entity
Organization
Contact information
Practice address
2550 COURT DR, SUITE 203, GASTONIA, NC 28054-2152
(704) 512-3636
(704) 334-7956
Mailing address
PO BOX 601381, CHARLOTTE, NC 28260-1381
(704) 512-3636
(704) 334-7956
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
Primary
—
—
Other
Enumeration date
04/15/2010
Last updated
12/02/2011
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