MEDICARE: DEARK MEDICAL CENTER PLLC

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	261QC1500X	Community Health Clinic/Center
2	261QM1000X	Migrant Health Clinic/Center
3	261QP2300X	Primary Care Clinic/Center
4	324500000X	Substance Abuse Rehabilitation Facility
5	207R00000X	Internal Medicine Physician	2016-01529	NC

General Provider Information

NPI Number	:	1376046003
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEARK MEDICAL CENTER PLLC

Provider Business Mailing Address
First Line	:	3719 LATROBE DR STE 840
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28211-5121
Country	:	US
Telephone Number	:	913-302-1470
Fax Number	:

Provider Business Practice Location Address
First Line	:	3719 LATROBE DR STE 840
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28211-5121
Country	:	US
Telephone Number	:	913-302-1470
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	EFEMWONKIEKIE WILLIAM IYAMU
Credential	:	MD
Telephone Number	:	913-302-1470

Provider Enumeration Date	:	03/08/2018
Last Update Date	:	02/06/2019

Similar Medicare Providers

1598604480 — SAINT FRANCIS HOME CARE
Practice Location Address:

6418 MALLARD VIEW LN
CHARLOTTE, NC
28269-5121

Practice Phone: 704-449-7932
Practice Fax:

1053684860 — OPTIMUM HORIZON LLC
Practice Location Address:

6412 MALLARD VIEW LN
CHARLOTTE, NC
28269-5121

Practice Phone: 980-721-7785
Practice Fax:

1013879931 — BREANNA JULEEN KING
Practice Location Address:

5121 BENTGRASS RUN DR
CHARLOTTE, NC
28269-6129

Practice Phone: 704-999-9488
Practice Fax:

1003771692 — ROOTED AND RISING COUNSELING PLLC
Practice Location Address:

5121 BENTGRASS RUN DR
CHARLOTTE, NC
28269-6129

Practice Phone: 704-999-9488
Practice Fax:

1912845595 — CARYLEE MICHELLE ORTIZ VALENTIN LCAS-A
Practice Location Address:

100 BILLINGSLEY RD
CHARLOTTE, NC
28211-1002

Practice Phone: 704-445-6882
Practice Fax: 704-376-3384

1518708718 — JENNIFER VICTORIA ADZIGIREY PA-C
Practice Location Address:

501 S SHARON AMITY RD STE 300
CHARLOTTE, NC
28211-0035

Practice Phone: 704-377-2424
Practice Fax:

Directions to “DEARK MEDICAL CENTER PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.