| Mecklenburg Medical Group | |
|
16455 Statesville Road Suite 200 Huntersville NC 28078-7125 | |
| (704) 367-6610 | |
| (704) 367-6650 |
| Full Name | Mecklenburg Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 16455 Statesville Road, Huntersville, North Carolina |
| Authorized Official Name and Position | Daniel L Wiens (SENIOR VICE PRESIDENT) |
| Authorized Official Contact | 7043550648 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mecklenburg Medical Group Po Box 60063 Charlotte NC 28260-0063 Ph: (704) 367-6610 | Mecklenburg Medical Group 16455 Statesville Road Suite 200 Huntersville NC 28078-7125 Ph: (704) 367-6610 |
| NPI Number | 1669797536 |
|---|---|
| Provider Enumeration Date | 04/02/2010 |
| Last Update Date | 04/02/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669797536 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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