Provider Demographics
NPI:1982700258
Name:NEPHROLOGY AND HYPERTENSION CONSULTANTS,PA
Entity type:Organization
Organization Name:NEPHROLOGY AND HYPERTENSION CONSULTANTS,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR
Authorized Official - Prefix:
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CARLUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-503-4400
Mailing Address - Street 1:8401 UNIVERSITY EXEC PARK DR STE 123
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-1358
Mailing Address - Country:US
Mailing Address - Phone:704-503-4400
Mailing Address - Fax:
Practice Address - Street 1:8401 UNIVERSITY EXEC PARK DR STE 123
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-1358
Practice Address - Country:US
Practice Address - Phone:704-503-4400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC39726174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCE67502Medicare UPIN