Metrolina Internal Medicine Pa

LBN: Metrolina Internal Medicine Pa
Metrolina Internal Medicine Pa is an health care organization with primary practice located at 2300 Randolph Rd Ste A , Charlotte NC 28207-1586. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. Metrolina Internal Medicine Pa can be contacted via phone (704) 372-9393, or through Ellis, Clarence O'Neil via phone (704) 372-9393.

Contact Information

Primary practice address
2300 Randolph Rd Ste A Charlotte NC 28207-1586
Phone: (704) 372-9393
Fax: (704) 372-0135
Website:
Map and Directions
Authorized official contact:
Name: Ellis, Clarence O'Neil Doctor of Medicine (MD)
Phone: (704) 372-9393

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 83588 North Carolina

Profile Details

NPI number 1326000845
LBN Legal business name Metrolina Internal Medicine Pa
DBA Doing business as
Authorized official Ellis, Clarence O'Neil Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 3rd, 2006
Last updated Apr 3rd, 2018 - about 6 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 1326000845 NPPES
North Carolina MEDICAID 790278J

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