Organization
CAROLINA PHYSICIANS GROUP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAY FERNANDO M.D. (PHYSICIAN)
(704) 378-4357
Entity
Organization
Contact information
Practice address
7615 COLONY RD STE 115, CHARLOTTE, NC 28226-5001
(704) 626-6812
(704) 626-6824
Mailing address
7615 COLONY RD STE 115, CHARLOTTE, NC 28226-5001
(704) 378-4357
(704) 626-6824
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0099-01172
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8912356
—
NC
05
—
891235U
—
NC
Enumeration date
07/04/2006
Last updated
11/12/2019
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