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General NPI Number Information
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NPI Number | 1477995082
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Entity Type | Organization
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Legal Business Name | CAROLINAS PHYSICIANS NETWORK, INC.
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Dates
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Enumeration Date | 07/24/2013
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Last Update Date | 01/07/2014
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Provider Practice Location Address
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Address Line | 823 E KING ST SUITE B
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City | KINGS MOUNTAIN
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State | NC
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Zip | 28086-3186
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Country | US
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Telephone | 980-487-2340
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Fax | 980-487-2341
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Provider Business Mailing Address
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Address Line | PO BOX 601884
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City | CHARLOTTE
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State | NC
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Zip | 28260-1884
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Country | US
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Telephone | 980-487-2340
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Fax | 980-487-2341
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Authorized Official
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Title or Position | SVP/OPERATIONS CPN
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Name | DANIEL L 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 | 208200000X
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Taxonomy Name | Plastic Surgery 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 | 2082S0105X
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Taxonomy Name | Surgery of the Hand (Plastic Surgery) Physician
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License Number |
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License Number State |
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