| Northeast Digestive Health Center Edison Square | |
|
10030 Edison Square Dr Nw Suite 204 Concord NC 28027-8308 | |
| (704) 783-1840 | |
| (704) 783-1850 |
| Full Name | Northeast Digestive Health Center Edison Square |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 10030 Edison Square Dr Nw, Concord, North Carolina |
| Authorized Official Name and Position | Mark Aldous (MANAGING PARTNER) |
| Authorized Official Contact | 7047831840 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Digestive Health Center Edison Square 1070 Vinehaven Dr Ne Concord NC 28025-2438 Ph: (704) 783-1840 | Northeast Digestive Health Center Edison Square 10030 Edison Square Dr Nw Suite 204 Concord NC 28027-8308 Ph: (704) 783-1840 |
| NPI Number | 1245776889 |
|---|---|
| Provider Enumeration Date | 01/06/2017 |
| Last Update Date | 01/06/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245776889 | NPI | - | NPPES |
| 1508279043 | Medicaid | NC | |
| 8971386 | Medicaid | NC | |
| 1194142422 | Medicaid | NC | |
| 710009300 | Medicaid | NC | |
| 891031V | Medicaid | NC | |
| 89136HK | Medicaid | NC | |
| 8926776 | Medicaid | NC | |
| 5904428 | Medicaid | NC | |
| 1396923322 | Other | NC | NPI |
| 89128WY | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | AS0104 (North Carolina) | Primary |
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