Healthcare Provider Details

I. General information

NPI: 1386093482
Provider Name (Legal Business Name): CATAWBA VALLEY MEDICAL GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2016
Last Update Date: 11/17/2023
Certification Date: 11/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3511 GRAYSTONE PL SE
CONOVER NC
28613-8201
US

IV. Provider business mailing address

PO BOX 890273
CHARLOTTE NC
28289-0273
US

V. Phone/Fax

Practice location:
  • Phone: 828-732-5600
  • Fax: 828-732-5601
Mailing address:
  • Phone: 828-326-9355
  • Fax: 828-326-9868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: PAMELA GALLAGHER
Title or Position: VP OF FINANCE/CFO
Credential:
Phone: 828-326-3800