Healthcare Provider Details
I. General information
NPI: 1528138781
Provider Name (Legal Business Name): ALBRIGHT INTERNAL MEDICINE, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/08/2006
Last Update Date: 07/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8810 BLAKENEY PROFESSIONAL DR SUITE 100
CHARLOTTE NC
28277-6595
US
IV. Provider business mailing address
8810 BLAKENEY PROFESSIONAL DR SUITE 100
CHARLOTTE NC
28277-6595
US
V. Phone/Fax
- Phone: 704-759-8188
- Fax: 704-759-0857
- Phone: 704-759-8188
- Fax: 704-759-0857
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | 9400697 |
| License Number State | NC |
VIII. Authorized Official
Name: MRS.
PAMELA
F
ALBRIGHT
Title or Position: PRACTICE MANAGEAR
Credential:
Phone: 704-759-8188