Organization
CHARLOTTE PRIMARY SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GONZALO OLIVERA (PRESIDENT)
(704) 763-5948
Entity
Organization
Contact information
Practice address
1235 EAST BLVD, CHARLOTTE, NC 28203-5870
(252) 470-8358
Mailing address
PO BOX 85073, # 51164, RICHMOND, VA 23285-5073
(704) 763-5948
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
11/30/2009
Last updated
01/05/2010
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