Organization
UROLOGY SPECIALISTS OF THE CAROLINAS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RALPH N VICK M.D. (PRESIDENT)
(704) 248-3400
Entity
Organization
Contact information
Practice address
325 HAWTHORNE LN STE 300, CHARLOTTE, NC 28204-2433
(704) 372-5180
(704) 376-6280
Mailing address
1518 EAST 3RD STREET, SUITE 250, CHARLOTTE, NC 28236-6488
(704) 248-3400
(704) 337-8387
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0279U
BLUE CROSS BLUE SHIELD
NC
05
—
5903371
—
NC
01
—
CF9758
RAILROAD MEDICARE PROV#
NC
Enumeration date
07/06/2006
Last updated
07/18/2017
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