Provider Demographics
NPI:1275955627
Name:CABARRUS MEDICAL CLINIC
Entity Type:Organization
Organization Name:CABARRUS MEDICAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARANIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-782-6868
Mailing Address - Street 1:1000 COPPERFIELD BLVD NE
Mailing Address - Street 2:SUITE 124
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-2453
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1000 COPPERFIELD BLVD NE
Practice Address - Street 2:SUITE 124
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2453
Practice Address - Country:US
Practice Address - Phone:704-782-6868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-19
Last Update Date:2014-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty