Provider Demographics
NPI:1063688968
Name:FIDELIS ENTERPRISES, INC.
Entity Type:Organization
Organization Name:FIDELIS ENTERPRISES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MULVIHILL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:704-547-7200
Mailing Address - Street 1:8220 UNIVERSITY EXEC PARK DR
Mailing Address - Street 2:SUITE 180
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-3380
Mailing Address - Country:US
Mailing Address - Phone:704-547-7200
Mailing Address - Fax:704-547-7333
Practice Address - Street 1:8220 UNIVERSITY EXEC PARK DR
Practice Address - Street 2:SUITE 180
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-3380
Practice Address - Country:US
Practice Address - Phone:704-547-7200
Practice Address - Fax:704-547-7333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1118111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty