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Carolina Medicorp Enterprises Inc

Organization Active NPI Emergency Medicine Physician · Bristow, VA

NPI 1689045239 · NPPES record last updated Oct 8, 2015

Key facts

NPI
1689045239
Entity type
Organization (NPI type 2)
Primary specialty
Emergency Medicine Physician 207P00000X
Legal business name
CAROLINA MEDICORP ENTERPRISES INC
Practice address
10322 Bristow Center Dr
Bristow, VA 20136-2201
Phone
(571) 284-4245
NPI assigned
Oct 8, 2015
Organization subpart
No

Authorized official

Name
Geoffery K Gardner
Title
VP of Finance
Phone
(571) 284-4245

Corporate family (same tax ID) 6

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Prmecare Medical Center (7 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207P00000X Yes
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X

Addresses

Primary practice location

10322 Bristow Center Dr
Bristow, VA 20136-2201

Mailing address

PO Box 751803
Charlotte, NC 28275-1803
Phone (571) 284-4245

Other names

  • Novant Health Urgent Care & Occupational Medicine Doing business as

Other providers in Bristow, VA

All providers in Bristow, VA · Emergency Medicine Physician in Virginia

Sources for this page

Verify at the official NPI Registry.