Healthcare Provider Details

I. General information

NPI: 1881682946
Provider Name (Legal Business Name): EMERGENCY MEDICINE PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 COURT DR
GASTONIA NC
28054-2140
US

IV. Provider business mailing address

6740 HONORS CT
CHARLOTTE NC
28210-4210
US

V. Phone/Fax

Practice location:
  • Phone: 704-834-2266
  • Fax:
Mailing address:
  • Phone: 604-552-5117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number31298
License Number StateNC

VIII. Authorized Official

Name: DR. MYRON BOHDAN HARMATY
Title or Position: EMERGENCY PHYSICIAN
Credential: MD
Phone: 704-834-2266