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Contact Information

CONCORD CHILDREN'S CLINIC
1040 VINEHAVEN DR,
CONCORD, NC28025
 Phone: 704-784-1010
 Fax: 704-784-1013
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for CONCORD CHILDRENS CLINIC · (Female)

NPI Number 1679589212
Status Active
Credentials
Entity Individual
Enumeration date 08/01/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • NC Medicaid 89015H6
  • NC Other 015H6 BCBS OF NC
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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