| Sensenbrenner Primary Care, Pllc | |
|
8821 Blakeney Professional Dr Charlotte NC 28277-6594 | |
| (704) 887-1101 | |
| (704) 887-1102 |
| Full Name | Sensenbrenner Primary Care, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 8821 Blakeney Professional Dr, Charlotte, North Carolina |
| Authorized Official Name and Position | John William Sensenbrenner (OWNER) |
| Authorized Official Contact | 7018871101 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sensenbrenner Primary Care, Pllc 8821 Blakeney Professional Dr Charlotte NC 28277-6594 Ph: (704) 887-1101 | Sensenbrenner Primary Care, Pllc 8821 Blakeney Professional Dr Charlotte NC 28277-6594 Ph: (704) 887-1101 |
| NPI Number | 1205813755 |
|---|---|
| Provider Enumeration Date | 12/27/2005 |
| Last Update Date | 10/25/2007 |
| Medicare PECOS PAC ID | 9234171315 |
|---|---|
| Medicare Enrollment ID | O20050531000241 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205813755 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | John W Sensenbrenner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043297591 PECOS PAC ID: 1355312554 Enrollment ID: I20040802001637 |
| Provider Name | Lori A Eaton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184916892 PECOS PAC ID: 0547434219 Enrollment ID: I20111114000890 |
| Provider Name | Zackery Shane Wood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659665289 PECOS PAC ID: 2365600749 Enrollment ID: I20190306000698 |
| Provider Name | Eric Daniel Sensenbrenner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083174148 PECOS PAC ID: 0042546327 Enrollment ID: I20220707002430 |
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