Organization
MERCY HEALTH SERVICES, INC.
Active
Other names
Eastover Internal Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL L WIENS (SENIOR VICE PRESIDENT)
(707) 355-0648
Entity
Organization
Contact information
Practice address
2608 E 7TH ST, CHARLOTTE, NC 28204-4375
(704) 344-9034
(704) 344-9544
Mailing address
5000 AIRPORT CENTER PKWY STE A, ATTN: SHANNA, CHARLOTTE, NC 28208-5899
(704) 512-4116
(704) 371-7284
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8902682
—
NC
Enumeration date
07/05/2006
Last updated
08/22/2020
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