Organization · NPI-2

Carolina Advanced Wellness, PLLC

Internal Medicine · Huntersville, NC

NPI number1417538497
StatusActive
Last updated in NPPESApr 20, 2021

Details

NPI
1417538497
Entity type
Organization (NPI-2)
Legal business name
Carolina Advanced Wellness, PLLC
Organization subpart
No
Enumeration date
Apr 20, 2021
Certification date
Apr 20, 2021
Last updated
Apr 20, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine––Yes

Practice location

16623 Birkdale Commons Pkwy Ste 120
Huntersville, NC 28078-5641

Phone 704-247-8355

Mailing address

11035 Golf Links Dr # 79217
Charlotte, NC 28277-8045

Authorized official

Jerry Allen Saunders
Owner
7043165635

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