Provider Demographics
NPI:1942956123
Name:METROLINA VASCULAR ACCESS CARE LLC
Entity Type:Organization
Organization Name:METROLINA VASCULAR ACCESS CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:BERLING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-971-8088
Mailing Address - Street 1:PO BOX 411225
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-1225
Mailing Address - Country:US
Mailing Address - Phone:610-644-8900
Mailing Address - Fax:
Practice Address - Street 1:3158 FREEDOM DR.
Practice Address - Street 2:#1101
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208
Practice Address - Country:US
Practice Address - Phone:704-971-8088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-25
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical