| Deark Medical Center Pllc | |
|
3719 Latrobe Dr Ste 840 Charlotte NC 28211-5121 | |
| (913) 302-1470 | |
| Not Available |
| Full Name | Deark Medical Center Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3719 Latrobe Dr Ste 840, Charlotte, North Carolina |
| Authorized Official Name and Position | Efemwonkiekie William Iyamu (PRESIDENT/CEO) |
| Authorized Official Contact | 9133021470 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Deark Medical Center Pllc 3719 Latrobe Dr Ste 840 Charlotte NC 28211-5121 Ph: (913) 302-1470 | Deark Medical Center Pllc 3719 Latrobe Dr Ste 840 Charlotte NC 28211-5121 Ph: (913) 302-1470 |
| NPI Number | 1376046003 |
|---|---|
| Provider Enumeration Date | 03/08/2018 |
| Last Update Date | 02/06/2019 |
| Medicare PECOS PAC ID | 3274897210 |
|---|---|
| Medicare Enrollment ID | O20180430000009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376046003 | NPI | - | NPPES |
| Provider Name | Efemwonkiekie Williams Iyamu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1649409301 PECOS PAC ID: 9830345248 Enrollment ID: I20170313000576 |
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