Provider Demographics
NPI:1245653872
Name:MEDREHAB SPECIALISTS OF NORTH CAROLINA, PA
Entity type:Organization
Organization Name:MEDREHAB SPECIALISTS OF NORTH CAROLINA, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:MOREJON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-626-2505
Mailing Address - Street 1:303 PERIMETER CTR N STE 300
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30346-3401
Mailing Address - Country:US
Mailing Address - Phone:404-596-5599
Mailing Address - Fax:
Practice Address - Street 1:6000 FAIRVIEW RD STE 1200
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-2252
Practice Address - Country:US
Practice Address - Phone:704-626-2505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-03
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2013-02202208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty