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General NPI Number Information
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NPI Number | 1194141978
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Entity Type | Organization
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Legal Business Name | CHARLOTTE MEDICAL CENTER PLLC
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Dates
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Enumeration Date | 03/17/2014
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Last Update Date | 03/17/2014
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Provider Practice Location Address
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Address Line | 7940 WILLIAMS POND LN SUITE 250
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City | CHARLOTTE
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State | NC
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Zip | 28277-8766
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Country | US
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Telephone | 704-542-2500
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Fax | 704-542-2592
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Provider Business Mailing Address
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Address Line | 7940 WILLIAMS POND LANE SUITE 250
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City | CHARLOTTE
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State | NC
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Zip | 28277-8412
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Country | US
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Telephone | 704-542-2500
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Fax | 704-542-2592
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Authorized Official
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Title or Position | OWNER
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Name | TUAN HUYNH
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Credential | M.D.
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Telephone | 704-542-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 140038
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License Number State | NC
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