Organization
SENIOR HEALTH CONNECTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL L. WIENS (SENIOR VICE PRESIDENT)
(704) 355-0648
Entity
Organization
Contact information
Practice address
7903 PROVIDENCE RD, SUITE 100, CHARLOTTE, NC 28277-9720
(704) 543-4360
(704) 544-2385
Mailing address
5000 AIRPORT CENTER PKWY STE A, CHARLOTTE, NC 28208-5899
(704) 512-4116
(704) 371-7284
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89011E1
—
NC
Enumeration date
07/10/2006
Last updated
08/22/2020
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