| Luke Medical Clinic, P.a. | |
|
125 W Catawba Ave Mt Holly NC 28120-1601 | |
| (704) 827-3014 | |
| (704) 822-9114 |
| Full Name | Luke Medical Clinic, P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 125 W Catawba Ave, Mt Holly, North Carolina |
| Authorized Official Name and Position | Gregory L Glass (OWNER) |
| Authorized Official Contact | 7048273014 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Luke Medical Clinic, P.a. 125 W Catawba Ave Mt Holly NC 28120-1601 Ph: (704) 827-3014 | Luke Medical Clinic, P.a. 125 W Catawba Ave Mt Holly NC 28120-1601 Ph: (704) 827-3014 |
| NPI Number | 1396918413 |
|---|---|
| Provider Enumeration Date | 04/09/2008 |
| Last Update Date | 11/08/2010 |
| Medicare PECOS PAC ID | 2466405105 |
|---|---|
| Medicare Enrollment ID | O20050223000093 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396918413 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 9401198 (North Carolina) | Primary |
| Provider Name | Gregory L Glass |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558353896 PECOS PAC ID: 7719930452 Enrollment ID: I20050303000240 |
| Provider Name | Kristal Rose Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598281677 PECOS PAC ID: 6002172814 Enrollment ID: I20171110002698 |
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