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General NPI Number Information
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NPI Number | 1205861002
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Entity Type | Individual
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Provider Name | THOMAS E. GETTELMAN PH.D.
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Gender | Male
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 05/27/2014
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Provider Practice Location Address
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Address Line | 16740 DAVIDSON CONCORD RD SUITE 200
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City | DAVIDSON
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State | NC
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Zip | 28036-8746
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Country | US
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Telephone | 704-801-9200
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Fax | 704-801-9201
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Provider Business Mailing Address
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Address Line | PO BOX 601372
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City | CHARLOTTE
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State | NC
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Zip | 28260-1372
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Country | US
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Telephone | 704-801-9200
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Fax | 704-801-9201
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1854
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License Number State | NC
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