Provider Demographics
NPI:1538700745
Name:GERIATRIC CARE OF THE CAROLINAS, PLLC
Entity Type:Organization
Organization Name:GERIATRIC CARE OF THE CAROLINAS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHAKEER
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHMOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-232-0635
Mailing Address - Street 1:PO BOX 102
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28070-0102
Mailing Address - Country:US
Mailing Address - Phone:704-232-0635
Mailing Address - Fax:704-866-0103
Practice Address - Street 1:6001 GRABURNS FORD DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-7120
Practice Address - Country:US
Practice Address - Phone:704-232-0635
Practice Address - Fax:704-866-0103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-30
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty