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NPI Code Detail

MEDICARE: MECKLENBURG COUNTY

MEDICARE: MECKLENBURG COUNTY
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
1261QP0905XState or Local Public Health Clinic/Center
2261QD0000XDental Clinic/Center
31223D0001XPublic Health Dentistry

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1015N0OTHERNCNC HEALTH CHOICE GROUP #
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1639195241
Entity Type Code : Organization
Provider Name (Legal Business Name) : MECKLENBURG COUNTY
Provider Business Mailing Address
First Line : 1801 ROZZELLES FERRY RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28208-4228
Country : US
Telephone Number : 704-350-7305
Fax Number : 704-350-7304
Provider Business Practice Location Address
First Line : 1801 ROZZELLES FERRY RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28208-4228
Country : US
Telephone Number : 704-350-7305
Fax Number : 704-350-7304
Authorized Official
Title or Position : HEALTH DIRECTOR
Name : EARL WINTERS MABRY
Credential : MD
Telephone Number : 704-336-2299
Provider Enumeration Date : 07/15/2006
Last Update Date : 12/13/2012

Similar Medicare Providers

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Practice Location Address:
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Practice Phone: 704-446-9987
Practice Fax:
1427991348 — DR. DEJA BLUNT MD, MS
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1003758152 — MIALIQUE DANIEL MD
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1346200359 — DR. JOHN JOSEPH DUGAN JR. DO
Practice Location Address:
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1790701308 — DR. HANI M ABOUFOUL DMD
Practice Location Address:
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1144240854 — DR. GARY R KUSHNER DDS
Practice Location Address:
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Practice Fax: 704-350-7304

Directions to “MECKLENBURG COUNTY ” Practice Location

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