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General NPI Number Information
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NPI Number | 1740429497
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Entity Type | Organization
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Legal Business Name | MEGREMIS GYNECOLOGY, PLLC
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Dates
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Enumeration Date | 02/19/2009
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Last Update Date | 01/25/2011
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Provider Practice Location Address
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Address Line | 13657 PROVIDENCE RD
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City | WEDDINGTON
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State | NC
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Zip | 28104-9373
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Country | US
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Telephone | 704-814-4963
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Fax | 704-814-6793
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Provider Business Mailing Address
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Address Line | 13657 PROVIDENCE RD
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City | WEDDINGTON
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State | NC
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Zip | 28104-9373
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Country | US
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Telephone | 704-814-4963
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Fax | 704-814-6793
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Authorized Official
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Title or Position | PHYSICIAN
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Name | TOMMY L MEGREMIS
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Credential | M.D.
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Telephone | 704-814-4963
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 32077
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License Number State | NC
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