Organization
EAGLE MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LHYNNE LESKO (BUSINESS ADMINISTRATOR)
(704) 934-5434
Entity
Organization
Contact information
Practice address
6005 HICKORY GROVE ROAD, CHARLOTTE, NC 28215-5104
(704) 945-6480
(704) 926-5439
Mailing address
6005 HICKORY GROVE ROAD, CHARLOTTE, NC 28215
(704) 945-6480
(704) 926-5439
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
200501333
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14096
BLUECROSS BLUESHIELD
NC
05
—
5913081
—
NC
Enumeration date
07/12/2011
Last updated
12/22/2011
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