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General NPI Number Information
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NPI Number | 1750457131
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Entity Type | Individual
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Provider Name | MARK R GABRYCH AU.D.
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Gender | Male
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 03/06/2015
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Provider Practice Location Address
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Address Line | 645 AMALIA STREET NE
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City | CONCORD
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State | NC
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Zip | 28025-2434
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Country | US
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Telephone | 704-295-3255
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Fax |
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Provider Business Mailing Address
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Address Line | 6035 FAIRVIEW RD
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City | CHARLOTTE
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State | NC
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Zip | 28210-3256
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Country | US
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Telephone | 704-295-3000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 7494
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License Number State | NC
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