Organization
CAROLINAS PHYSICIANS NETWORK INC
Active
Parent organization
CAROLINAS PHYSICIANS NETWORK INC
Other names
Sports Medicine and Injury Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
CAROLINAS PHYSICIANS NETWORK INC
Authorized official
DANIEL L WIENS (SVP/OPERATIONS)
(704) 355-0648
Entity
Organization
Contact information
Practice address
5651 POPLAR TENT RD, SUITE 200, CONCORD, NC 28027-7530
(704) 863-4878
Mailing address
PO BOX 602148, CHARLOTTE, NC 28260-2148
(704) 863-4878
Taxonomy
Speciality
Code
Description
License number
State
207RS0010X
Sports Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487091013
—
NC
01
—
4843180046
NC MEDICARE DME
NC
Enumeration date
05/22/2013
Last updated
01/10/2014
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