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NPI Code Detail

MEDICARE: CARMELLA LOUISE GISMONDI-EAGAN MD

MEDICARE: CARMELLA LOUISE GISMONDI-EAGAN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician2008-00009NC

General Provider Information

NPI Number : 1942205521
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARMELLA LOUISE GISMONDI-EAGAN MD
Provider Business Mailing Address
First Line : PO BOX 470408
Second Line :
City : CHARLOTTE
State : NC
Zip : 28247-0408
Country : US
Telephone Number : 704-375-0100
Fax Number : 704-887-6450
Provider Business Practice Location Address
First Line : 7845 LITTLE AVE
Second Line :
City : CHARLOTTE
State : NC
Zip : 28226-8198
Country : US
Telephone Number : 704-375-0100
Fax Number : 704-887-6450
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2005
Last Update Date : 04/10/2025

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Directions to “ CARMELLA LOUISE GISMONDI-EAGAN MD” Practice Location

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