Provider Demographics
NPI:1891325999
Name:WELLCOMEMD CHARLOTTE CLINIC PC
Entity Type:Organization
Organization Name:WELLCOMEMD CHARLOTTE CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:ACAMPORA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-444-0999
Mailing Address - Street 1:8035 PROVIDENCE RD STE 315
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-8909
Mailing Address - Country:US
Mailing Address - Phone:704-444-0999
Mailing Address - Fax:980-498-7007
Practice Address - Street 1:8035 PROVIDENCE RD STE 315
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-8909
Practice Address - Country:US
Practice Address - Phone:704-444-0999
Practice Address - Fax:980-498-7007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-17
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty