| Metrolina Medical Clinic, Pllc | |
|
1510 Orchard Lake Dr Suite A Charlotte NC 28270-1567 | |
| (704) 864-6584 | |
| Not Available |
| Full Name | Metrolina Medical Clinic, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1510 Orchard Lake Dr, Charlotte, North Carolina |
| Authorized Official Name and Position | Zina Falls (BILLING MANAGER) |
| Authorized Official Contact | 7048664607 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Metrolina Medical Clinic, Pllc 1510 Orchard Lake Dr Suite A Charlotte NC 28270-1567 Ph: () - | Metrolina Medical Clinic, Pllc 1510 Orchard Lake Dr Suite A Charlotte NC 28270-1567 Ph: (704) 864-6584 |
| NPI Number | 1447790662 |
|---|---|
| Provider Enumeration Date | 03/07/2017 |
| Last Update Date | 03/07/2017 |
| Medicare PECOS PAC ID | 8022389907 |
|---|---|
| Medicare Enrollment ID | O20170810003438 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447790662 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (North Carolina) | Primary |
| 363LP2300X | Nurse Practitioner - Primary Care | 5008453 (North Carolina) | Secondary |
| Provider Name | Donatus O Ogu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023070547 PECOS PAC ID: 0446238240 Enrollment ID: I20050118000964 |
| Provider Name | Godwin O Uzomba |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659376051 PECOS PAC ID: 2860526829 Enrollment ID: I20100813000137 |
| Provider Name | Ardelius Saye Boan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790147270 PECOS PAC ID: 7911292966 Enrollment ID: I20160830000683 |
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