Provider Demographics
NPI:1942703582
Name:INTEGRATED HEALTHCARE INNOVATION INC.
Entity Type:Organization
Organization Name:INTEGRATED HEALTHCARE INNOVATION INC.
Other - Org Name:NEW DAWN MEDICAL & INFECTIOUS DISEASE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-604-5677
Mailing Address - Street 1:3921 CAMERON CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-6772
Mailing Address - Country:US
Mailing Address - Phone:704-604-5677
Mailing Address - Fax:
Practice Address - Street 1:2325 W ARBORS DR STE 102
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-2664
Practice Address - Country:US
Practice Address - Phone:980-272-9192
Practice Address - Fax:980-819-8050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-09
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty