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Organization

CLEVELAND HEALTH VENTURES LLC

Active
Parent organization
CLEVELAND HEALTH VENTURES LLC
Other names
Shelby Family Practice
Organization subpart
Yes

Provider details

NPI number
Legal business name
CLEVELAND HEALTH VENTURES LLC
Authorized official
MR. DANIEL L. WIENS (SENIOR VICE PRESIDENT)
(704) 355-0648
Entity
Organization

Contact information

Practice address
708 MCBRAYER HOMESTEAD RD, SHELBY, NC 28152-9532
(704) 434-8123
(704) 434-9919
Mailing address
PO BOX 601884, CHARLOTTE, NC 28260-1884
(704) 434-8123
(704) 434-9919

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5906847
NC
05
NPB305
SC
Enumeration date
10/27/2009
Last updated
06/18/2013
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