| Carolina Family Healthcare, Pa | |
|
11220 Elm Ln Ste 102 Charlotte NC 28277-0716 | |
| (704) 847-4000 | |
| (704) 847-4001 |
| Full Name | Carolina Family Healthcare, Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 11220 Elm Ln Ste 102, Charlotte, North Carolina |
| Authorized Official Name and Position | Dino P Kanelos (OWNER) |
| Authorized Official Contact | 7048474000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina Family Healthcare, Pa 11220 Elm Ln Ste 102 Charlotte NC 28277-0716 Ph: (704) 847-4000 | Carolina Family Healthcare, Pa 11220 Elm Ln Ste 102 Charlotte NC 28277-0716 Ph: (704) 847-4000 |
| NPI Number | 1548529878 |
|---|---|
| Provider Enumeration Date | 05/07/2012 |
| Last Update Date | 02/28/2024 |
| Medicare PECOS PAC ID | 3577546662 |
|---|---|
| Medicare Enrollment ID | O20040610000138 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548529878 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Dino Peter Kanelos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306959705 PECOS PAC ID: 5092627620 Enrollment ID: I20040511001096 |
| Provider Name | Maureen Moore Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518258052 PECOS PAC ID: 0648426999 Enrollment ID: I20120907000349 |
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