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NPI Code Detail

MEDICARE: ROWAN DIAGNOSTIC CLINIC

MEDICARE: ROWAN DIAGNOSTIC CLINIC
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
1207K00000XAllergy & Immunology Physician39379NC

General Provider Information

NPI Number : 1215209820
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROWAN DIAGNOSTIC CLINIC
Provider Business Mailing Address
First Line : 611 MOCKSVILLE AVE
Second Line :
City : SALISBURY
State : NC
Zip : 28144-2705
Country : US
Telephone Number : 704-633-7220
Fax Number :
Provider Business Practice Location Address
First Line : 1035 DALE EARNHARDT BLVD
Second Line :
City : KANNAPOLIS
State : NC
Zip : 28083-4477
Country : US
Telephone Number : 704-633-7220
Fax Number :
Authorized Official
Title or Position : CEO
Name : PAUL A VERHAEGHE
Credential :
Telephone Number : 704-633-7220
Provider Enumeration Date : 01/30/2012
Last Update Date : 01/30/2012

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Directions to “ROWAN DIAGNOSTIC CLINIC ” Practice Location

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