Organization
CLEVELAND HEALTH VENTURES LLC
Active
Parent organization
CLEVELAND HEALTH VENTURES LLC
Other names
Kings Mountain Internal Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
CLEVELAND HEALTH VENTURES LLC
Authorized official
MR. DANIEL L. WIENS (SR. VICE PRESIDENT)
(704) 355-0648
Entity
Organization
Contact information
Practice address
502 W KING ST, SUITE A, KINGS MOUNTAIN, NC 28086-3362
(980) 487-2290
(704) 730-8472
Mailing address
PO BOX 601884, CHARLOTTE, NC 28260-1884
(980) 487-2290
(704) 730-8472
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5914428
—
NC
05
—
NPB348
—
SC
Enumeration date
10/07/2009
Last updated
01/25/2013
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