Organization
CLEVELAND HEALTH VENTURES LLC
Active
Parent organization
CLEVELAND HEALTH VENTURES LLC
Other names
Kings Mountain Infectious Disease
Organization subpart
Yes
Provider details
NPI number
Legal business name
CLEVELAND HEALTH VENTURES LLC
Authorized official
MR. DANIEL WIENS (SENIOR VICE PRESIDENT)
(704) 355-0648
Entity
Organization
Contact information
Practice address
502 W KING ST, SUITE B, KINGS MOUNTAIN, NC 28086-3362
(980) 487-2299
(704) 730-8262
Mailing address
PO BOX 602341, CHARLOTTE, NC 28260-2341
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5914028
—
NC
05
—
NPB363
—
SC
Enumeration date
10/05/2009
Last updated
06/28/2010
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