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General NPI Number Information
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NPI Number | 1184878753
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Entity Type | Organization
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Legal Business Name | MEDICAL ALLIANCE CLINIC, PLLC
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Dates
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Enumeration Date | 11/10/2008
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Last Update Date | 12/11/2009
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Provider Practice Location Address
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Address Line | 505 W FLEMING DR
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City | MORGANTON
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State | NC
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Zip | 28655-3923
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Country | US
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Telephone | 828-437-8158
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Fax | 828-438-9552
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Provider Business Mailing Address
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Address Line | 505 W FLEMING DR
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City | MORGANTON
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State | NC
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Zip | 28655-3923
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Country | US
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Telephone | 828-437-8158
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Fax | 828-438-9552
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | GREG LAWSON CLARY
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Credential | MD
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Telephone | 828-437-8158
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 9400753
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 9400753
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License Number State | NC
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