Modern Medical Group Pllc | |
936 Cox Rd Ste A Gastonia NC 28054-3456 | |
(704) 497-9544 | |
Not Available |
Full Name | Modern Medical Group Pllc |
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Speciality | Family Medicine |
Location | 936 Cox Rd Ste A, Gastonia, North Carolina |
Authorized Official Name and Position | Ivette Cintron-cubero (OWNER/PRESIDENT) |
Authorized Official Contact | 7044979544 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Modern Medical Group Pllc 10619 Trolley Run Dr Cornelius NC 28031-8303 Ph: (704) 497-9544 | Modern Medical Group Pllc 936 Cox Rd Ste A Gastonia NC 28054-3456 Ph: (704) 497-9544 |
NPI Number | 1861051591 |
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Provider Enumeration Date | 06/06/2019 |
Last Update Date | 06/06/2019 |
Medicare PECOS PAC ID | 4789916198 |
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Medicare Enrollment ID | O20191104001318 |
Identifier | Type | State | Issuer |
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1861051591 | NPI | - | NPPES |
56545-1730570136 | Medicaid | NC |
Provider Name | Marta M Kalinski |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1528249257 PECOS PAC ID: 4385807437 Enrollment ID: I20120529000608 |
Provider Name | Ivette Dianelle Cintron-cubero |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730570136 PECOS PAC ID: 4587975040 Enrollment ID: I20150624002287 |
Provider Name | Yvette L Walker |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1467999003 PECOS PAC ID: 9537428875 Enrollment ID: I20180113000042 |
Provider Name | Timothy Michael Looney |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1609523380 PECOS PAC ID: 5092199760 Enrollment ID: I20220829003518 |
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