Provider Demographics
NPI:1760771778
Name:HEALTHMED PC
Entity Type:Organization
Organization Name:HEALTHMED PC
Other - Org Name:CAROLINA SPINE AND PAIN MANAGEMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:PAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-599-0900
Mailing Address - Street 1:8821 UNIVERSITY EAST DRIVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-4201
Mailing Address - Country:US
Mailing Address - Phone:704-599-0900
Mailing Address - Fax:704-599-0998
Practice Address - Street 1:8821 UNIVERSITY EAST DRIVE
Practice Address - Street 2:SUITE 105
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-4201
Practice Address - Country:US
Practice Address - Phone:704-599-0900
Practice Address - Fax:704-599-0998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-30
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC36117207Q00000X
NC5005092363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty