MEDICARE: MDFAMILY MEDICAL GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1275716797
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MDFAMILY MEDICAL GROUP

Provider Business Mailing Address
First Line	:	4530 PARK RD STE 200
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28209-3790
Country	:	US
Telephone Number	:	704-527-6322
Fax Number	:

Provider Business Practice Location Address
First Line	:	5104 REAGAN DR STE 3
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28206-1392
Country	:	US
Telephone Number	:	704-598-2555
Fax Number	:

Authorized Official
Title or Position	:	AREA DIRECTOR
Name	:	HATTIE MURPHY
Credential	:
Telephone Number	:	704-527-6322

Provider Enumeration Date	:	12/06/2007
Last Update Date	:	02/11/2008

Similar Medicare Providers

1316806896 — CAROLINA PATH TO PROGRESS
Practice Location Address:

5104 REAGAN DR STE 2
CHARLOTTE, NC
28206-1392

Practice Phone: 602-731-1172
Practice Fax:

1003771866 — WE ARE ONE CHARLOTTE
Practice Location Address:

5104 REAGAN DR STE 1
CHARLOTTE, NC
28206-1392

Practice Phone: 704-480-3097
Practice Fax:

1730119363 — DR. TRASHA JACQUETTE BLACK PHD, LPC, NCC
Practice Location Address:

5104 REAGAN DR STE 5
CHARLOTTE, NC
28206-1392

Practice Phone: 704-596-0505
Practice Fax: 704-596-0507

1326187469 — GENESIS PROJECT 1, INC
Practice Location Address:

5104 REAGAN DR STE 5
CHARLOTTE, NC
28206-1392

Practice Phone: 704-596-0505
Practice Fax:

1104152172 — MS. TIONA T. WASHINGTON LPCA
Practice Location Address:

5104 REAGAN DR STE 5
CHARLOTTE, NC
28206-1392

Practice Phone: 704-596-0505
Practice Fax:

1639502792 — NEW CHOICES YOUTH & FAMILY SERVICES, INC.
Practice Location Address:

5104 REAGAN DR STE 7
CHARLOTTE, NC
28206-1392

Practice Phone: 704-352-4870
Practice Fax:

Directions to “MDFAMILY MEDICAL GROUP ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.