Healthcare Provider Details

I. General information

NPI: 1710979802
Provider Name (Legal Business Name): MIDTOWN & GYNECOLOGY ASSOCIATES P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1718 E 4TH ST SUITE 707
CHARLOTTE NC
28204-3260
US

IV. Provider business mailing address

1718 E 4TH ST SUITE 707
CHARLOTTE NC
28204-3260
US

V. Phone/Fax

Practice location:
  • Phone: 704-344-1000
  • Fax: 704-926-8098
Mailing address:
  • Phone: 704-344-1000
  • Fax: 704-926-8098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: GREGORY D PARKER
Title or Position: MANAGING PARTNER OF MIDTOWN OBGYN
Credential: M.D.
Phone: 704-344-1000