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General NPI Number Information
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NPI Number | 1437387750
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Entity Type | Organization
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Legal Business Name | CAROMONT MEDICAL GROUP INC
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Dates
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Enumeration Date | 06/25/2009
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Last Update Date | 07/27/2011
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Provider Practice Location Address
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Address Line | 701 W TRADE ST
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City | DALLAS
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State | NC
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Zip | 28034-1544
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Country | US
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Telephone | 704-922-3106
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Fax | 704-922-1369
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Provider Business Mailing Address
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Address Line | 701 W TRADE ST
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City | DALLAS
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State | NC
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Zip | 28034-1544
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Country | US
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Telephone | 704-922-3106
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Fax | 704-922-1369
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Authorized Official
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Title or Position | VP PRACTICE MANAGEMENT
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Name | CRAIG A. DUNKER
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Credential |
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Telephone | 704-834-2135
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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