Mecklenburg Medical Group

LBN: Mecklenburg Medical Group
Mecklenburg Medical Group is an health care organization with primary practice located at 7903 Providence Rd Suite 100, Charlotte NC 28277-9720. The organization recently has 9 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism, Allopathic & Osteopathic Physicians / Gastroenterology, Allopathic & Osteopathic Physicians / Hematology & Oncology, Allopathic & Osteopathic Physicians / Infectious Disease, Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Rheumatology. Allopathic & Osteopathic Physicians / Internal Medicine is the primary health care specialty. Mecklenburg Medical Group can be contacted via phone (704) 367-8610, or through Wiens, Daniel L via phone (704) 355-0648.

Contact Information

Primary practice address
7903 Providence Rd Suite 100 Charlotte NC 28277-9720
Phone: (704) 367-8610
Fax: (704) 367-6798
Website:
Map and Directions
Authorized official contact:
Name: Wiens, Daniel L
Phone: (704) 355-0648

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism 207RE0101X
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X
Allopathic & Osteopathic Physicians / Rheumatology 207RR0500X

Profile Details

NPI number 1255364535
LBN Legal business name Mecklenburg Medical Group
DBA Doing business as
Authorized official Wiens, Daniel L
Entity Organization
Organization subpart 1 No
Enumeration date Jul 9th, 2006
Last updated Mar 6th, 2013 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255364535 NPPES
South Carolina MEDICAID E08621
South Carolina MEDICAID 5902311
South Carolina MEDICAID 89013CO
South Carolina MEDICAID 89013CW
South Carolina MEDICAID 89013CY
South Carolina MEDICAID 5903117
South Carolina MEDICAID 89013AF
South Carolina MEDICAID 5901377
South Carolina MEDICAID 5905557
South Carolina MEDICAID 89015NA
South Carolina MEDICAID 89013PP
South Carolina MEDICAID 89013CX

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