MEDICARE: PROMED HEALTHCARE, PLLC

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	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1750572368
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROMED HEALTHCARE, PLLC

Provider Business Mailing Address
First Line	:	7004 SMITH CORNERS BLVD
Second Line	:	SUITE A
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-3793
Country	:	US
Telephone Number	:	704-688-9650
Fax Number	:	704-688-9651

Provider Business Practice Location Address
First Line	:	7004 SMITH CORNERS BLVD
Second Line	:	SUITE A
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-3793
Country	:	US
Telephone Number	:	704-688-9650
Fax Number	:	704-688-9651

Authorized Official
Title or Position	:	MEMBER/MANAGER
Name	:	DANIEL PETER SEWARD
Credential	:	M.D
Telephone Number	:	704-688-9650

Provider Enumeration Date	:	08/08/2007
Last Update Date	:	07/10/2013

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