Healthcare Provider Details

I. General information

NPI: 1629351580
Provider Name (Legal Business Name): CATAWBA VALLEY MEDICAL GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2011
Last Update Date: 11/17/2023
Certification Date: 11/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 FAIRGROVE CHURCH RD
HICKORY NC
28602-9617
US

IV. Provider business mailing address

810 FAIRGROVE CHURCH RD
HICKORY NC
28602-9617
US

V. Phone/Fax

Practice location:
  • Phone: 828-326-3809
  • Fax: 828-326-3371
Mailing address:
  • Phone: 828-326-3809
  • Fax: 828-326-3371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal 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