Provider Demographics
NPI:1598181885
Name:PROMED PRIMARY AND EXPRESS CARE PLLC
Entity Type:Organization
Organization Name:PROMED PRIMARY AND EXPRESS CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:SEWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-564-9491
Mailing Address - Street 1:18504 HAMMOCK LN
Mailing Address - Street 2:
Mailing Address - City:DAVIDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28036-8839
Mailing Address - Country:US
Mailing Address - Phone:704-564-9491
Mailing Address - Fax:
Practice Address - Street 1:7004 SMITH CORNERS BLVD
Practice Address - Street 2:STE A
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-3793
Practice Address - Country:US
Practice Address - Phone:704-688-9650
Practice Address - Fax:704-688-9651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-11
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC199863208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty