Provider Demographics
NPI:1578677712
Name:CHOTINER FAMILY HEALTHCARE, PA
Entity Type:Organization
Organization Name:CHOTINER FAMILY HEALTHCARE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARTIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:CHOTINER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-279-1046
Mailing Address - Street 1:316 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROCKWELL
Mailing Address - State:NC
Mailing Address - Zip Code:28138-8471
Mailing Address - Country:US
Mailing Address - Phone:704-279-1046
Mailing Address - Fax:704-279-1603
Practice Address - Street 1:316 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ROCKWELL
Practice Address - State:NC
Practice Address - Zip Code:28138-8471
Practice Address - Country:US
Practice Address - Phone:704-279-1046
Practice Address - Fax:704-279-1603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89016RTMedicaid