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General NPI Number Information
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NPI Number | 1548401888
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Entity Type | Organization
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Legal Business Name | HORMONAL HEALTH AND WELLNESS CENTER, P.A.
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Dates
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Enumeration Date | 03/17/2009
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Last Update Date | 03/17/2009
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Provider Practice Location Address
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Address Line | 16600 BIRKDALE CMNS PKWY SUITE D
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-6181
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Country | US
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Telephone | 704-896-1876
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Fax | 704-624-3841
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Provider Business Mailing Address
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Address Line | 16600 BIRKDALE CMNS PKWY SUITE D
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-6181
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Country | US
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Telephone | 704-896-1876
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Fax | 704-624-3841
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GEORGE LOREN GAUNT
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Credential | M.D., PH.D.
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Telephone | 704-896-1876
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 27047
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License Number State | NC
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