Gapover Md, Pllc | |
5023 Weddington Matthews Rd Matthews NC 28104-9413 | |
(704) 724-0909 | |
(704) 846-0538 |
Full Name | Gapover Md, Pllc |
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Speciality | Family Medicine |
Location | 5023 Weddington Matthews Rd, Matthews, North Carolina |
Authorized Official Name and Position | Everlyn L Hall Baker (CEO) |
Authorized Official Contact | 7047240909 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Gapover Md, Pllc 5023 Weddington Matthews Rd Matthews NC 28104-9413 Ph: (704) 724-0909 | Gapover Md, Pllc 5023 Weddington Matthews Rd Matthews NC 28104-9413 Ph: (704) 724-0909 |
NPI Number | 1114370988 |
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Provider Enumeration Date | 07/18/2016 |
Last Update Date | 07/18/2016 |
Medicare PECOS PAC ID | 1456622653 |
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Medicare Enrollment ID | O20170807001860 |
Identifier | Type | State | Issuer |
---|---|---|---|
1114370988 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 33372 (North Carolina) | Primary |
Provider Name | Everlyn Hall-baker |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1174574149 PECOS PAC ID: 5496750572 Enrollment ID: I20060923000024 |
Provider Name | Raymond Tanwani Tah |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518482710 PECOS PAC ID: 0345516761 Enrollment ID: I20171030001125 |
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