Organization
PEDIATRIC ENDOCRINOLOGY & DIABETES SPECIALISTS
Active
Organization
PEDIATRIC ENDOCRINOLOGY & DIABETES SPECIALISTS
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
709 N DEKALB ST, SHELBY, NC 28150-3911
(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
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5902857
—
NC
Enumeration date
03/15/2010
Last updated
04/03/2012
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