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Organization

IREDELL PHYSICIAN NETWORK LLC

Active
Parent organization
IREDELL PHYSICIAN NETWORK LLC
Other names
Nicholson Internal Medicine
Organization subpart
Yes

Provider details

NPI number
Legal business name
IREDELL PHYSICIAN NETWORK LLC
Authorized official
CARLA D JOHNSON (DIRECTOR OF OPERATIONS)
(704) 873-5661
Entity
Organization

Contact information

Practice address
728 HARTNESS RD, STATESVILLE, NC 28677-3425
(704) 230-4382
(704) 253-4085
Mailing address
PO BOX 896199, CHARLOTTE, NC 28289-6199
(833) 936-1364
(312) 277-5144

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Enumeration date
02/18/2022
Last updated
02/18/2022
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