Basic Information
| Provider Information | |||||||||
| NPI: | 1225083918 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | THE HAND CENTER OF THE CAROLINAS, P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 760 N NEW HOPE RD | ||||||||
| Address2: | SUITE A | ||||||||
| City: | GASTONIA | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28054 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7048668976 | ||||||||
| FaxNumber: | 7048668680 | ||||||||
| Practice Location | |||||||||
| Address1: | 760 N NEW HOPE RD | ||||||||
| Address2: | SUITE A | ||||||||
| City: | GASTONIA | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28054 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7048668976 | ||||||||
| FaxNumber: | 7048668680 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | MCMAHAN | ||||||||
| AuthorizedOfficialFirstName: | DANIEL | ||||||||
| AuthorizedOfficialMiddleName: | SCOTT | ||||||||
| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 7048668976 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 9600398 | NC | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 890227L | 05 | NC | MEDICAID | 0227L | 01 | NC | BCBS | OTHER |