Organization
GRACE FAMILY CARE, PC
Active
Organization
GRACE FAMILY CARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE C PAMINTUAN M.D. (CEO)
(704) 921-6659
Entity
Organization
Contact information
Practice address
10616 METROMONT PKWY, SUITE 104, CHARLOTTE, NC 28269-7657
(704) 921-6659
(704) 921-6698
Mailing address
10616 METROMONT PKWY, SUITE 104, CHARLOTTE, NC 28269-7656
(704) 921-6659
(704) 921-6698
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
N 97 00121
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891070P
—
NC
Enumeration date
03/08/2010
Last updated
03/08/2010
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