Organization
THE CAROLINA MEN'S CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL BEAUCHAINE PA (PHYSICIAN ASSISTANT)
(704) 981-4490
Entity
Organization
Contact information
Practice address
122 GATEWAY BLVD STE D, MOORESVILLE, NC 28117-5544
(704) 981-4490
Mailing address
122 GATEWAY BLVD STE D, MOORESVILLE, NC 28117-5544
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
0010-05337
NC
Other
Enumeration date
11/13/2014
Last updated
11/13/2014
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