Organization
FAMILY HEALTHCARE OF LAKE NORMAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VINCENT MARK WINEGARDNER (ADMINISTRATOR)
(704) 987-7970
Entity
Organization
Contact information
Practice address
9718 SAM FURR RD, STE. A, HUNTERSVILLE, NC 28078-4978
(704) 987-7970
(704) 987-8221
Mailing address
9718 SAM FURR RD, STE. A, HUNTERSVILLE, NC 28078-4978
(704) 987-7970
(704) 987-8221
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9801807
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891178M
—
NC
Enumeration date
01/09/2008
Last updated
08/05/2008
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