Organization
POLYCLINIC MEDICAL CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOSI BRAZ GARUBA (CEO)
(704) 844-8971
Entity
Organization
Contact information
Practice address
9705 NORTHEAST PKWY STE 400, MATTHEWS, NC 28105-9704
(704) 844-8971
(704) 844-8972
Mailing address
9705 NORTHEAST PKWY STE 400, MATTHEWS, NC 28105-9704
(704) 844-8971
(704) 844-8972
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
2000-01378
NC
208000000X
Pediatrics Physician
25646
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5903156
—
NC
Enumeration date
03/31/2006
Last updated
06/08/2020
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