Healthcare Provider Details

I. General information

NPI: 1255450235
Provider Name (Legal Business Name): FREEDOM MEDICAL CLINIC & URGENT CARE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 07/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2905 FREEDOM DRIVE
CHARLOTTE NC
28208-3857
US

IV. Provider business mailing address

2905 FREEDOM DRIVE
CHARLOTTE NC
28208-3857
US

V. Phone/Fax

Practice location:
  • Phone: 704-394-3033
  • Fax: 704-394-3395
Mailing address:
  • Phone: 704-394-3033
  • Fax: 704-394-3395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. NDOFUNSU BADIKA
Title or Position: OWNER
Credential: MD
Phone: 704-394-3033