Healthcare Provider Details

I. General information

NPI: 1356933261
Provider Name (Legal Business Name): JZ COMPREHENSIVE MEDICAL CONSULTANTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2021
Last Update Date: 03/04/2021
Certification Date: 03/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7615 COLONY RD STE 115
CHARLOTTE NC
28226-5001
US

IV. Provider business mailing address

115 SARDIS MILL DR
MATTHEWS NC
28105-6508
US

V. Phone/Fax

Practice location:
  • Phone: 980-272-7213
  • Fax: 888-613-3583
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SHUQIN YAN
Title or Position: PARTNER
Credential:
Phone: 704-839-6996