Healthcare Provider Details

I. General information

NPI: 1346308517
Provider Name (Legal Business Name): CABARRUS GASTROENTEROLOGY ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 11/06/2023
Certification Date: 11/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1070 VINEHAVEN DR NE
CONCORD NC
28025-2438
US

IV. Provider business mailing address

1070 VINEHAVEN DR
CONCORD NC
28025-2438
US

V. Phone/Fax

Practice location:
  • Phone: 704-783-1840
  • Fax: 704-783-1850
Mailing address:
  • Phone: 704-783-1840
  • Fax: 704-783-1850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0800X
TaxonomyEndoscopy Clinic/Center
License Number
License Number StateNC

VIII. Authorized Official

Name: DR. MARK ALDOUS
Title or Position: MANAGING PARTNER
Credential: MD
Phone: 704-783-1840