Provider Demographics
NPI:1972902195
Name:ACCESS CARE MEDICAL, PLLC
Entity type:Organization
Organization Name:ACCESS CARE MEDICAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AUGUSTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ONWUKWE
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:704-910-2199
Mailing Address - Street 1:PO BOX 29540
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28229-9540
Mailing Address - Country:US
Mailing Address - Phone:704-910-2199
Mailing Address - Fax:704-910-2545
Practice Address - Street 1:5412 CENTRAL AVE
Practice Address - Street 2:A
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-2706
Practice Address - Country:US
Practice Address - Phone:704-910-2199
Practice Address - Fax:704-910-2545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-14
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty