Healthcare Provider Details
I. General information
NPI: 1841741014
Provider Name (Legal Business Name): RDMG ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/21/2016
Last Update Date: 07/16/2021
Certification Date: 07/16/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
304 S GREEN ST
MORGANTON NC
28655-3578
US
IV. Provider business mailing address
PO BOX 63103
CHARLOTTE NC
28263-3103
US
V. Phone/Fax
- Phone: 828-438-1125
- Fax: 828-438-1119
- Phone: 919-233-5952
- Fax: 312-324-7850
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAVID
MOYE
Title or Position: DIRECTOR
Credential:
Phone: 919-614-0301