MEDICARE: PHILITA WING

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1346912060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILITA WING

Provider Business Mailing Address
First Line	:	7721 PETREA LN
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28227-1061
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7721 PETREA LN
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28227-1061
Country	:	US
Telephone Number	:	803-522-1958
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2021
Last Update Date	:	02/02/2026

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Directions to “ PHILITA WING ” Practice Location

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