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General NPI Number Information
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NPI Number | 1053651034
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Entity Type | Organization
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Legal Business Name | CAROLINAS HEALTHCARE SYSTEM
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Dates
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Enumeration Date | 02/27/2013
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Last Update Date | 02/27/2013
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Provider Practice Location Address
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Address Line | 1010 EDGEHILL RD N DEPARTMENT OF NEUROLOGY
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City | CHARLOTTE
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State | NC
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Zip | 28207-1885
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Country | US
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Telephone | 704-355-9434
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Fax | 704-355-9296
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Provider Business Mailing Address
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Address Line | 1010 EDGEHILL RD N DEPARTMENT OF NEUROLOGY
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City | CHARLOTTE
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State | NC
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Zip | 28207-1885
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Country | US
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Telephone | 704-355-9434
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Fax | 704-355-9296
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Authorized Official
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Title or Position | SENIOR SCIENTIST/PHYSICAL THERAPIST
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Name | PROF. MOHAMMED S SANJAK
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Credential | PHD, PT
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Telephone | 704-355-9434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | 11465
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License Number State | NC
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