Provider Demographics
NPI:1689726655
Name:CHOICE CARE FAMILY MEDICAL CENTER PC
Entity Type:Organization
Organization Name:CHOICE CARE FAMILY MEDICAL CENTER PC
Other - Org Name:PASQUALE D BARATTA MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PASQUALE
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:BARATTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-846-1911
Mailing Address - Street 1:2435 PLANTATION CENTER DRIVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-5148
Mailing Address - Country:US
Mailing Address - Phone:704-846-1911
Mailing Address - Fax:704-846-1960
Practice Address - Street 1:2435 PLANTATION CENTER DRIVE
Practice Address - Street 2:SUITE 110
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5148
Practice Address - Country:US
Practice Address - Phone:704-846-1911
Practice Address - Fax:704-846-1960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9300020207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0264GOtherBCBS
NC0264GOtherBCBS
2191715CMedicare ID - Type Unspecified