Basic Information
| Provider Information | |||||||||
| NPI: | 1992464002 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HNI MEDICAL SERVICES OF NORTH CAROLINA, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30575 BAINBRIDGE RD | ||||||||
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| City: | SOLON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441392221 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4405425000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3643 N ROXBORO ST FL 6 | ||||||||
| Address2: | |||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 277042702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9845694040 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/16/2021 | ||||||||
| LastUpdateDate: | 12/16/2021 | ||||||||
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| AuthorizedOfficialLastName: | CARLETTI | ||||||||
| AuthorizedOfficialFirstName: | RYAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT OF OPERATIONS | ||||||||
| AuthorizedOfficialTelephone: | 4405425000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 12/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.