MEDICARE: DR. GAGE ALEXANDER STUNTZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	PENDING	NC
2	207P00000X	Emergency Medicine Physician	55395	KY
3	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1285193102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GAGE ALEXANDER STUNTZ MD

Provider Business Mailing Address
First Line	:	726 FREDRICKSBURG RD
Second Line	:
City	:	MATTHEWS
State	:	NC
Zip	:	28105-2653
Country	:	US
Telephone Number	:	704-712-5778
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 BLYTHE BLVD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28203-5871
Country	:	US
Telephone Number	:	704-712-5778
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2019
Last Update Date	:	05/23/2024

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