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General NPI Number Information
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NPI Number | 1245776889
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Entity Type | Organization
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Legal Business Name | CABARRUS GASTROENTEROLOGY ASSOCIATES, PLLC
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Dates
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Enumeration Date | 01/06/2017
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Last Update Date | 01/06/2017
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Provider Practice Location Address
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Address Line | 10030 EDISON SQUARE DR NW SUITE 204
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City | CONCORD
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State | NC
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Zip | 28027-8308
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Country | US
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Telephone | 704-783-1840
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Fax | 704-783-1850
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Provider Business Mailing Address
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Address Line | 1070 VINEHAVEN DR NE
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City | CONCORD
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State | NC
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Zip | 28025-2438
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Country | US
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Telephone | 704-783-1840
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Fax | 704-783-1850
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | MARK ALDOUS
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Credential | MD
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Telephone | 704-783-1840
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | AS0104
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License Number State | NC
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