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3330 Siskey Parkway Matthews NC 28105 | |
| (704) 316-2127 | |
| (704) 316-2136 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 3330 Siskey Parkway, Matthews, North Carolina |
| Authorized Official Name and Position | Geoffrey Gardner (VP OF OPERATIONS) |
| Authorized Official Contact | 70438499094 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 60447 Charlotte NC 28260-0447 Ph: (704) 384-7840 | 3330 Siskey Parkway Matthews NC 28105 Ph: (704) 316-2127 |
| NPI Number | 1376726935 |
|---|---|
| Provider Enumeration Date | 12/06/2007 |
| Last Update Date | 08/05/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376726935 | NPI | - | NPPES |
| NPB258 | Medicaid | SC | |
| 019U2 | Other | NC | BCBS-NC |
| 5908614 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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