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THE GOSLEN AESTHETIC & SKIN CENTER NPI 1134149842


NPI Information

NPI: 1134149842
Provider Name: THE GOSLEN AESTHETIC & SKIN CENTER

Other Name: J BLAKE GOSLEN MD PA

Classification: Clinic/Center - 261QM2500X
Entity Type: Organization

Specialization: Medical Specialty

Address:
1918 RANDOLPH RD
SUITE 550
CHARLOTTE, NC
ZIP 28207
Phone: (704) 375-6766
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THE GOSLEN AESTHETIC & SKIN CENTER is a medical specialty clinic center in Charlotte, NC. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). THE GOSLEN AESTHETIC & SKIN CENTER NPI is 1134149842. The provider is registered as an organization entity type.
The provider Other Name Is J Blake Goslen Md Pa.

The provider's business location address is:

1918 RANDOLPH RD
SUITE 550
CHARLOTTE, NC
ZIP 28207-100
Phone: (704) 375-6766

The provider's authorized official is Girish Munavalli .
The authorized official title is Medical Director and has the following contact phone number (704) 375-6766.

The enumeration date for this NPI number is 7/19/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM2500XClinic/CenterMedical SpecialtyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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