Healthcare Provider Details

I. General information

NPI: 1982920690
Provider Name (Legal Business Name): KELVIN ANG GOLD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2010
Last Update Date: 10/26/2020
Certification Date: 09/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 OLD LEXINGTON RD
THOMASVILLE NC
27360-3428
US

IV. Provider business mailing address

PO BOX 60447
CHARLOTTE NC
28260-0447
US

V. Phone/Fax

Practice location:
  • Phone: 336-474-3444
  • Fax: 336-474-8111
Mailing address:
  • Phone: 336-474-3444
  • Fax: 336-474-8111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number266141
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2016-00027
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: