MARIETTA MEDICAL CLINIC, PA (NPI# 1912142167) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912142167 |
| Entity Type | Organization |
| Organization Name | MARIETTA MEDICAL CLINIC, PA |
| Practice Address |
401 S Marietta St Gastonia NC 28052-4331 |
| Mailing Address |
Po Box 550457 Gastonia NC 28055-0457 |
| Practice Telephone | 7048668030 |
| Mailing Telephone | 7048668030 |
| Enumeration Date | 2008-12-02 |
| Last Update Date | 2009-03-12 |
| Authorized Official Name | DR. IFEANYI O OKAFOR (PRESIDENT) |
| Authorized Official Telephone | 7048668030 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 200200150 | NC | Other Service Providers |
| Street Address |
401 S MARIETTA ST |
| City | GASTONIA |
| State | NC |
| Zip Code | 28052-4331 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609864446 | Charles Kanyo Agunobi | Internal Medicine | 401 S Marietta St, Gastonia, NC 28052-4331 | 2005-10-06 |
| 1215165659 | Marietta Medical Clinic Pa | Clinic/Center | 401 S Marietta St, Gastonia, NC 28052-4331 | 2009-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053859488 | Aa Plus Family Care Services, LLC | Custodial Care Facility | 190- B South Street, Gastonia, NC 28052 | 2017-02-06 |
| 1487028098 | Stefanie Mann | Counselor | 165 West Franklin Blvd., Gastonia, NC 28052 | 2015-11-19 |
| 1659771343 | Latisha Marsh | Pharmacist | 233 North Myrtle School, Gastonia, NC 28052 | 2014-08-29 |
| 1730598616 | Erin Flitt | Nurse Practitioner | 425 North Marietta Street, Gastoni, NC 28052 | 2014-08-05 |
| 1568877199 | Ebony Kyerra Kennedy | Pharmacist | 2206 West Franklin Blvd, Gastonia, NC 28052 | 2014-06-23 |
| 1821364209 | Harcharan Singh | Ophthalmology | 111 E.third Avenue, Gaston Family Medical Center, Gastonia, NC 28052 | 2012-03-29 |
| 1437475365 | Evelyn B Mcgill | Counselor | 102 N Yates Street, Gastonia, NC 28052 | 2010-04-16 |
| 1568696680 | Fafli Inc | Community/Behavioral Health | 175 W. Main Avenue, Gaston County, NC 28052 | 2009-05-04 |
| 1558570630 | Peggy May Currie | Physical Therapist | 710 Marietta St., Suite B, Gastonia, NC 28052 | 2007-05-22 |
| 1275753352 | John Theodore Fox | Dentist | 601 S York St, Gastonia, NC 28052 | 2007-04-30 |
| Find all providers in zip 28052 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| 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. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891070579 | Scott Alan Meyer | Specialist | 2550 Court Dr Ste 101, Gastonia, NC 28054-2152 | 2011-10-13 |
| 1366633463 | Gihwala & Associates | Specialist | 825 Majestic Ct Ste A, Gastonia, NC 28054-5190 | 2007-08-05 |
| 1962629493 | Gaston Digestive Disease Clinic, P.a. | Specialist | 2550 Court Dr Ste 201, Gastonia, NC 28054-2152 | 2007-04-19 |
| 1043332786 | Aman Raj | Specialist | 561 Cox Road, Gastonia, NC 28054-0628 | 2007-04-04 |
| 1699897249 | Austin Azubike Osemeka | Specialist | 2682 Court Dr Ste A, Gastonia, NC 28054-1449 | 2007-04-04 |
| 1104836048 | Kelly F Shedd | Specialist | 2391 Court Dr Ste 110, Gastonia, NC 28054-2197 | 2006-08-09 |
| 1053367490 | Pain Management Associates, P.a. | Specialist | 640 Summitt Xing Pl, Suite 200, Gastonia, NC 28054-2138 | 2006-05-26 |
| 1093785099 | William S. Watkins | Specialist | 2450 Aberdeen Blvd, Suite A, Gastonia, NC 28054-0606 | 2006-01-24 |
| 1487632873 | Southeastern Specialist Clinic | Specialist | 825 Majestic Ct, Suite F, Gastonia, NC 28054-5186 | 2006-01-05 |
| 1699760702 | Ent Carolina Pa | Specialist | 2520 Aberdeen Blvd, Gastonia, NC 28054-0635 | 2005-09-14 |
| Find all providers in GASTONIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.