Organization
BALSAM HEALTH OF THE CAROLINAS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RADWAN IBRAHIM MD (OWNER/MEMBER)
(704) 941-4485
Entity
Organization
Contact information
Practice address
607 W GROVER ST STE 101, SHELBY, NC 28150-2816
(704) 866-0101
(704) 866-0103
Mailing address
PO BOX 6449, CONCORD, NC 28027-1525
(704) 866-0101
(704) 866-0103
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
9701414
NC
Other
Enumeration date
06/04/2018
Last updated
06/04/2018
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