Organization
CAROLINAS PHYSICIANS NETWORK INC
Active
Parent organization
CAROLINAS PHYSICIANS NETWORK INC
Other names
Carolina Breast Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
CAROLINAS PHYSICIANS NETWORK INC
Authorized official
DANIEL LESLIE WIENS (SVP/OPERATIONS CPN)
(704) 355-0648
Entity
Organization
Contact information
Practice address
154 AMENDMENT AVE, ROCK HILL, SC 29732-3155
(803) 329-8990
Mailing address
PO BOX 602478, CHARLOTTE, NC 28260-2478
(803) 329-8990
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP6360
—
SC
Enumeration date
10/22/2013
Last updated
02/25/2014
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