Healthcare Provider Details
I. General information
NPI: 1659775831
Provider Name (Legal Business Name): CARELON MEDICAL PARTNERS OF NORTH CAROLINA PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/16/2014
Last Update Date: 01/03/2025
Certification Date: 01/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1100 N RALEIGH BLVD
RALEIGH NC
27610-1076
US
IV. Provider business mailing address
12900 PARK PLAZA DR STE 150
CERRITOS CA
90703-9329
US
V. Phone/Fax
- Phone: 919-838-2887
- Fax: 919-838-2888
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0002X |
| Taxonomy | Hospice and Palliative Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TIMOTHY
ALBION
Title or Position: PRESIDENT
Credential: MD
Phone: 212-476-4176