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NPI Code Detail

MEDICARE: CAROMONT MEDICAL GROUP INC

MEDICARE: CAROMONT MEDICAL GROUP INC
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
1207R00000XInternal Medicine Physician
2207RC0200XCritical Care Medicine (Internal Medicine) Physician
3207RE0101XEndocrinology, Diabetes & Metabolism Physician
4207RG0100XGastroenterology Physician
5207RH0002XHospice and Palliative Medicine (Internal Medicine) Physician
6207RI0200XInfectious Disease Physician
7207RR0500XRheumatology Physician
8207V00000XObstetrics & Gynecology Physician
9207VM0101XMaternal & Fetal Medicine Physician
10208000000XPediatrics Physician
112084N0400XNeurology Physician
122084P0800XPsychiatry Physician
13208600000XSurgery Physician
14208M00000XHospitalist Physician
15207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1356314272
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAROMONT MEDICAL GROUP INC
Provider Business Mailing Address
First Line : PO BOX 744786
Second Line :
City : ATLANTA
State : GA
Zip : 30374-4786
Country : US
Telephone Number : 704-834-2450
Fax Number : 704-671-5331
Provider Business Practice Location Address
First Line : 2315 COURT DR
Second Line :
City : GASTONIA
State : NC
Zip : 28054-2151
Country : US
Telephone Number : 704-834-2450
Fax Number : 704-671-5331
Authorized Official
Title or Position : CFO
Name : DAVID MICHAEL OCONNOR
Credential :
Telephone Number : 704-834-2049
Provider Enumeration Date : 02/10/2006
Last Update Date : 08/09/2022

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Directions to “CAROMONT MEDICAL GROUP INC ” Practice Location

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