MEDICARE: NMG HEALTH SERVICES, LLC

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	207VM0101X	Maternal & Fetal Medicine Physician

General Provider Information

NPI Number	:	1326735838
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NMG HEALTH SERVICES, LLC

Provider Business Mailing Address
First Line	:	PO BOX 60447
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-0447
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1450 MATTHEWS TOWNSHIP PKWY STE 410
Second Line	:
City	:	MATTHEWS
State	:	NC
Zip	:	28105-5336
Country	:	US
Telephone Number	:	704-384-5701
Fax Number	:	704-384-5642

Authorized Official
Title or Position	:	RCS MANAGER
Name	:	DOREATHA ROGERS
Credential	:
Telephone Number	:	980-302-7992

Provider Enumeration Date	:	04/24/2023
Last Update Date	:	04/24/2023

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