MEDICARE: UNION PHYSICIANS NETWORK INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134412117
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNION PHYSICIANS NETWORK INC

Provider Business Mailing Address
First Line	:	PO BOX 602583
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-2583
Country	:	US
Telephone Number	:	704-515-4808
Fax Number	:	704-512-4838

Provider Business Practice Location Address
First Line	:	5955 WEDDINGTON RD
Second Line	:
City	:	WESLEY CHAPEL
State	:	NC
Zip	:	28104-6273
Country	:	US
Telephone Number	:	704-667-4280
Fax Number	:	704-667-4281

Authorized Official
Title or Position	:	SENIOR VICE PRESIDENT
Name	:	DANIEL WIENS
Credential	:
Telephone Number	:	704-355-0648

Provider Enumeration Date	:	05/24/2011
Last Update Date	:	03/28/2012

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Directions to “UNION PHYSICIANS NETWORK INC ” Practice Location

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