Provider Demographics
NPI:1154690931
Name:METRO MEDICAL HOUSE CALLS,PC
Entity type:Organization
Organization Name:METRO MEDICAL HOUSE CALLS,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EDGAR
Authorized Official - Middle Name:STUART
Authorized Official - Last Name:CORNETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-252-6369
Mailing Address - Street 1:PO BOX 36388
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28236-6388
Mailing Address - Country:US
Mailing Address - Phone:304-252-6339
Mailing Address - Fax:
Practice Address - Street 1:1709 EAST BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-5823
Practice Address - Country:US
Practice Address - Phone:704-333-6642
Practice Address - Fax:704-332-6642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-22
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care