Healthcare Provider Details

I. General information

NPI: 1629272646
Provider Name (Legal Business Name): CAROLINAS MEDICAL CENTER-UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2007
Last Update Date: 08/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8800 N TRYON ST
CHARLOTTE NC
28262-3300
US

IV. Provider business mailing address

PO BOX 601372
CHARLOTTE NC
28260-1372
US

V. Phone/Fax

Practice location:
  • Phone: 704-512-7562
  • Fax: 704-512-4808
Mailing address:
  • Phone: 704-512-7562
  • Fax: 704-512-4808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. THOMAS FORD LAYMON
Title or Position: SVP
Credential:
Phone: 704-631-0002