Provider Demographics
NPI:1033172960
Name:UNITED SLEEP MEDICINE ASSOCIATES PA
Entity Type:Organization
Organization Name:UNITED SLEEP MEDICINE ASSOCIATES PA
Other - Org Name:UNITED SLEEP MEDICINE ASSOCIATES PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:STAFF ACCOUNTANT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:A
Authorized Official - Last Name:REEP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-927-7300
Mailing Address - Street 1:5821 FAIRVIEW RD
Mailing Address - Street 2:SUITE 415
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-3649
Mailing Address - Country:US
Mailing Address - Phone:704-377-5337
Mailing Address - Fax:704-377-9992
Practice Address - Street 1:5821 FAIRVIEW RD
Practice Address - Street 2:SUITE 409
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-3754
Practice Address - Country:US
Practice Address - Phone:704-377-5337
Practice Address - Fax:704-377-9992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-11
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2084N0400X, 2084S0012X
NC261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder DiagnosticGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
011HVOtherBCBS
NC89011HVMedicaid
NC011HVOtherBCBS OF NC
011HVOtherBCBS