Healthcare Provider Details

I. General information

NPI: 1598764367
Provider Name (Legal Business Name): LINCOLN CENTER FOR WOMEN'S HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 E GASTON ST
LINCOLNTON NC
28092-4400
US

IV. Provider business mailing address

1460 E GASTON ST
LINCOLNTON NC
28092-4400
US

V. Phone/Fax

Practice location:
  • Phone: 704-735-2134
  • Fax: 704-735-6784
Mailing address:
  • Phone: 704-735-2134
  • Fax: 704-735-6784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number94000931
License Number StateNC

VIII. Authorized Official

Name: DR. BERNIECE E REDMOND
Title or Position: PRESIDENT
Credential: M.D.
Phone: 704-735-2134