Healthcare Provider Details

I. General information

NPI: 1811914260
Provider Name (Legal Business Name): DORIS CATHERINE PATE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 S MAIN ST
MOUNT HOLLY NC
28120-1620
US

IV. Provider business mailing address

215 S MAIN ST
MOUNT HOLLY NC
28120-1620
US

V. Phone/Fax

Practice location:
  • Phone: 704-587-2400
  • Fax: 704-587-2401
Mailing address:
  • Phone: 704-587-2400
  • Fax: 704-587-2401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number36002
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: