| Promed NC PLLC | |
|
176 Mine Lake Ct Ste 100 Raleigh NC 27615-6417 | |
| (615) 499-3165 | |
| Not Available |
| Full Name | Promed NC PLLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 176 Mine Lake Ct Ste 100, Raleigh, North Carolina |
| Authorized Official Name and Position | Lev Grinman (PRESIDENT) |
| Authorized Official Contact | 6466731660 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Promed NC PLLC 329 S Oyster Bay Rd # 2059 Plainview NY 11803-3301 | Promed NC PLLC 176 Mine Lake Ct Ste 100 Raleigh NC 27615-6417 Ph: (615) 499-3165 |
| NPI Number | 1053206540 |
|---|---|
| Provider Enumeration Date | 06/12/2025 |
| Last Update Date | 03/05/2026 |
| Certification Date | 03/05/2026 |
| Medicare PECOS PAC ID | 6608370051 |
|---|---|
| Medicare Enrollment ID | O20250918001473 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053206540 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (NU) | Primary |
| Provider Name | Erin Salas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295486413 PECOS PAC ID: 1850786187 Enrollment ID: I20220323000286 |
| Provider Name | Jennifer Meehan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548333032 PECOS PAC ID: 5395843130 Enrollment ID: I20260115003548 |
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