Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Indian Trail Family Medicine

Organization Family Medicine Physician · NPI 1003842782

Indian Trail Family Medicine is a Family Medicine Physician in Indian Trail, North Carolina. Registered with an NPI since 2006.

In the registry since
2006

Practice location Address checks out

4503 Old Monroe Rd
Indian Trail, NC 28079-5309
Phone: (704) 821-6900
Fax: (704) 821-6911
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1003842782
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Daniel Wiens — Senior Vice President · (704) 355-0648
NPI enumeratedJune 24, 2006
Last updated in NPPESFebruary 12, 2008
Mailing address5000 Airport Center Pkwy Ste A, Charlotte, NC 28208-5899

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