Provider Demographics
NPI:1073281374
Name:CONCERTOCARE MEDICAL GROUP OF NORTH CAROLINA, PC
Entity Type:Organization
Organization Name:CONCERTOCARE MEDICAL GROUP OF NORTH CAROLINA, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LONI
Authorized Official - Middle Name:R
Authorized Official - Last Name:BELYEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-553-3591
Mailing Address - Street 1:PO BOX 801280
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-1280
Mailing Address - Country:US
Mailing Address - Phone:470-553-3591
Mailing Address - Fax:
Practice Address - Street 1:215 FENWAY ROAD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-1409
Practice Address - Country:US
Practice Address - Phone:877-597-1440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-01
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty