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CAROLINA CLINIC FOR DIGESTIVE DISEASES NPI 1700965902


NPI Information

NPI: 1700965902
Provider Name: CAROLINA CLINIC FOR DIGESTIVE DISEASES
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
1040 X RAY DR
STE B
GASTONIA, NC
ZIP 28054
Phone: (704) 854-9990
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CAROLINA CLINIC FOR DIGESTIVE DISEASES is a specialist in Gastonia, NC. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. CAROLINA CLINIC FOR DIGESTIVE DISEASES NPI is 1700965902. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1040 X RAY DR
STE B
GASTONIA, NC
ZIP 28054-438
Phone: (704) 854-9990
Fax: (704) 854-9045

The provider's authorized official is William Caddick .
The authorized official title is President and has the following contact phone number (704) 854-9990.

The enumeration date for this NPI number is 11/6/2006 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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist33956NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
18902001MEDICAIDNORTH CAROLINA

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: 5/5/2024

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