Organization
COMMUNITY MEDICAL, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BRANDI SELINA QUEEN FNP (PRESIDENT)
(704) 292-0708
Entity
Organization
Contact information
Practice address
520 W MAIN ST, MARSHVILLE, NC 28103-1197
(704) 624-3388
(704) 624-3390
Mailing address
520 W MAIN ST, MARSHVILLE, NC 28103-1197
(704) 624-3388
(704) 624-3390
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
32725
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0132J
BCBS
—
05
—
890132J
—
NC
Enumeration date
07/27/2007
Last updated
04/30/2024
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