Organization
CAROLINA EXPRESS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY S CHAMBERS PA-C (OWNER/PROVIDER)
(704) 572-0154
Entity
Organization
Contact information
Practice address
5110 PARK RD, 1J, CHARLOTTE, NC 28209
(704) 496-9100
Mailing address
5110 PARK RD 1J, CHARLOTTE, NC 28209
(704) 572-0154
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
001000254
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659346492
NPI TYPE I: 1659346492
NC
Enumeration date
09/06/2013
Last updated
06/13/2014
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