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General NPI Number Information
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NPI Number | 1982972501
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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 | 12/09/2011
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Last Update Date | 01/08/2013
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Provider Practice Location Address
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Address Line | 1178 OLD CAROLEEN ROAD
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City | FOREST CITY
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State | NC
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Zip | 28043-3710
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Country | US
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Telephone | 828-245-4061
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Fax | 828-245-4062
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Provider Business Mailing Address
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Address Line | PO BOX 602148
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City | CHARLOTTE
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State | NC
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Zip | 28260-2148
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Country | US
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Telephone | 828-245-4061
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Fax | 828-245-4062
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Authorized Official
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Title or Position | SENIOR VICE PRESIDENT OF OPERATIONS
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Name | MR. 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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State | NC
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