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General NPI Number Information
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NPI Number | 1467700872
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Entity Type | Organization
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Legal Business Name | CAROLINAS MEDICAL CENTER
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Dates
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Enumeration Date | 08/16/2012
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Last Update Date | 10/09/2012
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Provider Practice Location Address
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Address Line | 1010 EDGEHILL RD N SUITE B
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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 | 704-446-1900
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Fax | 704-446-1555
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Provider Business Mailing Address
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Address Line | PO BOX 601372
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City | CHARLOTTE
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State | NC
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Zip | 28260-1372
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Country | US
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Telephone | 704-446-1900
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Fax | 704-446-1555
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Authorized Official
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Title or Position | SENIOR VICE PRESIDENT OF OPERATIONS
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Name | DANIEL WIENS
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Credential |
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Telephone | 704-355-0648
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084S0012X
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Taxonomy Name | Sleep Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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