Provider Demographics
NPI:1508688847
Name:VALE MEDICAL CLINIC
Entity type:Organization
Organization Name:VALE MEDICAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:ELAM
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:704-477-7135
Mailing Address - Street 1:9576 W NC 10 HWY
Mailing Address - Street 2:
Mailing Address - City:VALE
Mailing Address - State:NC
Mailing Address - Zip Code:28168-9409
Mailing Address - Country:US
Mailing Address - Phone:704-477-7135
Mailing Address - Fax:
Practice Address - Street 1:9576 W NC 10 HWY
Practice Address - Street 2:
Practice Address - City:VALE
Practice Address - State:NC
Practice Address - Zip Code:28168-9409
Practice Address - Country:US
Practice Address - Phone:980-484-3630
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-28
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty