Provider Demographics
NPI:1528138781
Name:ALBRIGHT INTERNAL MEDICINE, PA
Entity type:Organization
Organization Name:ALBRIGHT INTERNAL MEDICINE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGEAR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:F
Authorized Official - Last Name:ALBRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-759-8188
Mailing Address - Street 1:8810 BLAKENEY PROFESSIONAL DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-6595
Mailing Address - Country:US
Mailing Address - Phone:704-759-8188
Mailing Address - Fax:704-759-0857
Practice Address - Street 1:8810 BLAKENEY PROFESSIONAL DR
Practice Address - Street 2:SUITE 100
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-6595
Practice Address - Country:US
Practice Address - Phone:704-759-8188
Practice Address - Fax:704-759-0857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9400697261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC10585OtherBCBS
NC10585OtherBCBS