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General NPI Number Information
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NPI Number | 1679700843
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Entity Type | Organization
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Legal Business Name | NEW HOPE MEDICAL CLINIC, PC
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Dates
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Enumeration Date | 06/16/2009
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Last Update Date | 10/02/2018
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Provider Practice Location Address
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Address Line | 3670 S NEW HOPE RD STE 1
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City | GASTONIA
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State | NC
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Zip | 28056
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Country | US
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Telephone | 704-824-4560
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Fax | 704-824-4560
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Provider Business Mailing Address
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Address Line | 3670 S NEW HOPE RD STE 1
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City | GASTONIA
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State | NC
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Zip | 28056-8597
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Country | US
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Telephone | 704-709-3239
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Fax | 704-478-8194
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Authorized Official
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Title or Position | MANAGER
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Name | KONRAD HELMUT KAEDING
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Credential |
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Telephone | 302-518-3022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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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 | 9300173
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 17583
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License Number State | NC
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