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General NPI Number Information
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NPI Number | 1932366028
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Entity Type | Individual
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Provider Name | ANITA HOPKINS GODWIN P.A.C.
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Gender | Female
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Dates
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Enumeration Date | 05/18/2008
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Last Update Date | 05/12/2014
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Provider Practice Location Address
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Address Line | 1875 REMOUNT RD
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City | GASTONIA
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State | NC
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Zip | 28054-7413
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Country | US
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Telephone | 704-874-0600
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Fax | 704-865-4785
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Provider Business Mailing Address
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Address Line | 200 E 2ND AVE
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City | GASTONIA
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State | NC
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Zip | 28052-4358
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Country | US
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Telephone | 704-874-1904
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Fax | 704-867-2134
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0010-01294
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-01294
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License Number State | NC
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