Organization
CAROLINA PEDIATRIC CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLIVIA B MIJUMBI MD (MEDICAL DIRECTOR)
(704) 864-0303
Entity
Organization
Contact information
Practice address
239 WILMOT DR STE A, GASTONIA, NC 28054-4048
(704) 864-0303
(704) 864-6070
Mailing address
PO BOX 550818, GASTONIA, NC 28055-0818
(704) 864-0303
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12-01098
UNITEDHEALTHCARE
NC
01
—
1322Y
BCBS
NC
01
—
2900124
AETNA
NC
05
—
891322Y
—
NC
01
—
9259849
PHCS
MA
01
—
9554744001
CIGNA
NC
01
—
A8708
MEDCOST
NC
Enumeration date
07/25/2013
Last updated
02/01/2023
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up