Provider Demographics
NPI:1811954647
Name:METROLINA ORTHOPAEDIC AND SPORTS MEDICINE CLINIC
Entity type:Organization
Organization Name:METROLINA ORTHOPAEDIC AND SPORTS MEDICINE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:ESTWANIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-334-4663
Mailing Address - Street 1:335 BILLINGSLEY RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-1040
Mailing Address - Country:US
Mailing Address - Phone:704-334-4663
Mailing Address - Fax:704-343-0811
Practice Address - Street 1:335 BILLINGSLEY RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-1040
Practice Address - Country:US
Practice Address - Phone:704-334-4663
Practice Address - Fax:704-343-0811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18633207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty