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General NPI Number Information
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NPI Number | 1922158203
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Entity Type | Organization
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Legal Business Name | CMG- FAMILY MEDICINE OF CLEVELAND COUNTY LLC
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 04/12/2010
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Provider Practice Location Address
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Address Line | 807 SCHENCK ST # 3
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City | SHELBY
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State | NC
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Zip | 28150-3933
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Country | US
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Telephone | 704-480-0222
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Fax | 704-480-6007
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Provider Business Mailing Address
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Address Line | 2240 REMOUNT RD
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City | GASTONIA
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State | NC
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Zip | 28054-4725
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Country | US
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Telephone | 704-671-5311
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Fax | 704-671-5308
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Authorized Official
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Title or Position | PRESIDENT,CEO
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Name | MR. VALINDA L RUTLEDGE
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Credential |
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Telephone | 704-834-2133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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