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NPI Code Detail

MEDICARE: CHRISTIAN PETERSEN GAGE MD

MEDICARE: CHRISTIAN PETERSEN GAGE 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
1208600000XSurgery Physician2025-02356NC

General Provider Information

NPI Number : 1346635802
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTIAN PETERSEN GAGE MD
Provider Business Mailing Address
First Line : 1000 BLYTHE BLVD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28203-5871
Country : US
Telephone Number : 704-355-2000
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 : 704-355-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2015
Last Update Date : 10/10/2025

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