| Carol J Soucie, MD | |
|
6555 Kee Ln Ste 200, Harrisburg, NC 28075-7463 | |
| (704) 316-6140 | |
| (704) 316-6141 |
| Full Name | Carol J Soucie |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 6555 Kee Ln Ste 200, Harrisburg, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023080066 | NPI | - | NPPES |
| 344285 | Other | NC | MAMSI |
| 18356 | Other | NC | PARTNERS MEDICARE CHOICE |
| 36213 | Other | NC | MEDCOST |
| 8978447 | Medicaid | NC | |
| 4293938 | Other | NC | AETNA |
| 160721 | Other | NC | WELLPATH |
| 78447 | Other | NC | BCBS |
| 566000156 | Other | NC | PRACTICE TAX ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 36600 (North Carolina) | Primary |
| Entity Name | Novant Health Medical Group, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1366409492 PECOS PAC ID: 1153234893 Enrollment ID: O20031121000692 |
| Mailing Address | Practice Location Address |
|---|---|
| Carol J Soucie, MD Po Box 60447, Charlotte, NC 28260-0447 Ph: () - | Carol J Soucie, MD 6555 Kee Ln Ste 200, Harrisburg, NC 28075-7463 Ph: (704) 316-6140 |
Amirah Lachaune Shareef, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 5427 Nc Highway 49 S, Ste 103, Harrisburg, NC 28075 Phone: 704-455-5565 | |
Dr. Colleen Rochelle Black, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 6555 Kee Ln Ste 200, Harrisburg, NC 28075 Phone: 704-316-6140 Fax: 704-316-6141 | |
Marianna Gagina, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 5427 Nc Highway 49 S, Ste 103, Harrisburg, NC 28075 Phone: 704-455-5565 | |
Geetika Gupta, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 5427 Nc Highway 49 S, Ste 103, Harrisburg, NC 28075 Phone: 704-455-5565 | |
Erica Lauren Jones, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 5427 Nc Highway 49 S, Ste 103, Harrisburg, NC 28075 Phone: 704-455-5565 | |
Jubayer Ahmed, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 6555 Kee Ln Ste 200, Harrisburg, NC 28075 Phone: 704-316-6140 Fax: 704-316-6141 |