Healthcare Provider Details

I. General information

NPI: 1750572368
Provider Name (Legal Business Name): PROMED HEALTHCARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2007
Last Update Date: 07/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7004 SMITH CORNERS BLVD SUITE A
CHARLOTTE NC
28269-3793
US

IV. Provider business mailing address

7004 SMITH CORNERS BLVD SUITE A
CHARLOTTE NC
28269-3793
US

V. Phone/Fax

Practice location:
  • Phone: 704-688-9650
  • Fax: 704-688-9651
Mailing address:
  • Phone: 704-688-9650
  • Fax: 704-688-9651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DANIEL PETER SEWARD
Title or Position: MEMBER/MANAGER
Credential: M.D
Phone: 704-688-9650