OrganizationActive
Access Direct Primary Care, PLLC
NPI 1639957889 · Internal Medicine Physician · Charlotte, NC
Provider details
- NPI number
- 1639957889
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Yenny Vander Waerden, Member(510) 506-3200
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
6225 Blakeney Park Dr Ste B
Charlotte, NC 28277-5658
Phone: (248) 587-6037
Approximate (ZIP-level) locationGet directions
Mailing address
6225 Blakeney Park Dr Ste B
Charlotte, NC 28277-5658
Registry dates
- Enumerated
- 2023-09-19
- Last updated
- 2023-10-02
- Certified
- 2023-10-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.