Organization Name: | INDIAN TRAIL MEDICAL CLINIC, INC. |
NPI Number: | 1790823672 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GEORGE S.C. TSAI (MEDICAL DOCTOR) |
Mailing Address: | 301 S. Indian Trail Road Indian Trail |
State: | NC US |
Postal Code: | 28079 |
Phone Number: | 7048217056 |
Fax Number: | 7048217057 |
NPI Enumeration Date: | 02/02/2007 |
NPI Last Update Date: | 01/28/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 22284 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |