Organization
UNION PHYSICIANS NETWORK INC
Active
Parent organization
UNION PHYSICIANS NETWORK INC
Other names
Indian Trail Pediatrics
Organization subpart
Yes
Provider details
NPI number
Legal business name
UNION PHYSICIANS NETWORK INC
Authorized official
MR. DANIEL L WIENS (SENIOR VICE PRESIDENT)
(704) 355-0648
Entity
Organization
Contact information
Practice address
6030 W HIGHWAY 74, SUITE F, INDIAN TRAIL, NC 28079-3468
(704) 246-2900
(704) 246-2899
Mailing address
PO BOX 601892, CHARLOTTE, NC 28260-1892
(704) 246-2900
(704) 246-2899
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5905684
—
NC
Enumeration date
11/27/2006
Last updated
08/19/2011
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