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General NPI Number Information
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NPI Number | 1417137787
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Entity Type | Organization
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Legal Business Name | METROLINA NEUROLOGICAL ASSOCIATES
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Dates
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Enumeration Date | 11/05/2007
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Last Update Date | 11/05/2007
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Provider Practice Location Address
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Address Line | 10620 PARK RD STE 230
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City | CHARLOTTE
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State | NC
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Zip | 28210-0106
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Country | US
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Telephone | 704-542-6698
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Fax |
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Provider Business Mailing Address
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Address Line | 10620 PARK RD STE 230
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City | CHARLOTTE
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State | NC
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Zip | 28210-0106
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Country | US
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Telephone | 704-542-6698
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | DR. HOWARD MANDELL
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Credential | M.D.
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Telephone | 803-366-6135
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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 |
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License Number State |
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