Healthcare Provider Details

I. General information

NPI: 1033459532
Provider Name (Legal Business Name): CAROLINA EMG SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2013
Last Update Date: 10/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1899 TATE BLVD SE SUITE 2108
HICKORY NC
28602-4200
US

IV. Provider business mailing address

6401 STARGAZE LN
CHARLOTTE NC
28269-0802
US

V. Phone/Fax

Practice location:
  • Phone: 704-607-3483
  • Fax: 704-464-1818
Mailing address:
  • Phone: 704-607-3483
  • Fax: 704-464-1818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251E1300X
TaxonomyClinical Electrophysiology Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DAVID J DUMOND
Title or Position: OWNER
Credential: DPT
Phone: 704-607-3483