Healthcare Provider Details

I. General information

NPI: 1508688847
Provider Name (Legal Business Name): VALE MEDICAL CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2024
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9576 W NC 10 HWY
VALE NC
28168-9409
US

IV. Provider business mailing address

9576 W NC 10 HWY
VALE NC
28168-9409
US

V. Phone/Fax

Practice location:
  • Phone: 980-484-3630
  • Fax:
Mailing address:
  • Phone: 704-477-7135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOEL DOUGLAS ELAM
Title or Position: OWNER
Credential: PA-C
Phone: 704-477-7135