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NPI Code Detail

MEDICARE: DR. MARY CAROLYN POMEROY

MEDICARE: DR. MARY CAROLYN POMEROY
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
12085R0202XDiagnostic Radiology Physician23318NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336148436
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARY CAROLYN POMEROY
Provider Business Mailing Address
First Line : 1701 EAST BLVD
Second Line : CHARLOTTE RADIOLOGY
City : CHARLOTTE
State : NC
Zip : 28203-5823
Country : US
Telephone Number : 704-334-7800
Fax Number : 704-334-7818
Provider Business Practice Location Address
First Line : 600 HOSPITAL DR
Second Line : UNION REGIONAL MEDICAL CENTER
City : MONROE
State : NC
Zip : 28112-6000
Country : US
Telephone Number : 704-334-7800
Fax Number : 704-334-7818
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2005
Last Update Date : 07/08/2007

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Directions to “ DR. MARY CAROLYN POMEROY ” Practice Location

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