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General NPI Number Information
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NPI Number | 1760771778
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Entity Type | Organization
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Legal Business Name | HEALTHMED PC
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Dates
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Enumeration Date | 03/30/2011
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Last Update Date | 12/07/2011
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Provider Practice Location Address
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Address Line | 8821 UNIVERSITY EAST DRIVE SUITE 105
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City | CHARLOTTE
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State | NC
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Zip | 28213-4201
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Country | US
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Telephone | 704-599-0900
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Fax | 704-599-0998
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Provider Business Mailing Address
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Address Line | 8821 UNIVERSITY EAST DRIVE SUITE 105
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City | CHARLOTTE
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State | NC
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Zip | 28213-4201
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Country | US
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Telephone | 704-599-0900
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Fax | 704-599-0998
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | NEIL PAI
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Credential |
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Telephone | 704-599-0900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5005092
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 36117
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License Number State | NC
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