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General NPI Number Information
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NPI Number | 1013248905
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Entity Type | Organization
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Legal Business Name | CAROLINA NEUROLOGY EAST
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Dates
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Enumeration Date | 01/18/2010
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Last Update Date | 01/18/2010
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Provider Practice Location Address
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Address Line | 223 HOSPITAL ST
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City | MOCKSVILLE
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State | NC
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Zip | 27028-2038
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Country | US
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Telephone | 704-924-7575
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Fax | 704-924-7877
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Provider Business Mailing Address
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Address Line | 750 HARTNESS RD STE E
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City | STATESVILLE
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State | NC
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Zip | 28677-3400
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Country | US
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Telephone | 704-924-7575
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Fax | 704-924-7877
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Authorized Official
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Title or Position | OWNER
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Name | TRISHWANT GARCHA
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Credential | MD
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Telephone | 704-924-7575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 200001134
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License Number State | NC
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