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General NPI Number Information
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NPI Number | 1508182361
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Entity Type | Organization
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Legal Business Name | NEAD MEDICAL PC.
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Dates
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Enumeration Date | 04/19/2010
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Last Update Date | 04/19/2010
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Provider Practice Location Address
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Address Line | 10504 PARK RD
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City | CHARLOTTE
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State | NC
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Zip | 28210-8405
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Country | US
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Telephone | 704-319-9045
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Fax | 704-319-9046
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Provider Business Mailing Address
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Address Line | 10504 PARK RD
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City | CHARLOTTE
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State | NC
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Zip | 28210-8405
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Country | US
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Telephone | 704-319-9045
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Fax | 704-319-9046
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Authorized Official
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Title or Position | MRDICAL DIRECTOR
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Name | DR. ADEWUNMI AKANDE
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Credential | MD
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Telephone | 704-319-9045
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | 97-01215
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 97-01215
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License Number State | NC
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