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GASTON MEDICAL ASSOCIATES PA NPI 1366433773


NPI Information

NPI: 1366433773
Provider Name: GASTON MEDICAL ASSOCIATES, PA
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 34D0974742

Address:
2664 COURT DRIVE
SUITE A
GASTONIA, NC
ZIP 28054
Phone: (704) 861-9030
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GASTON MEDICAL ASSOCIATES, PA is an internal medicine in Gastonia, NC. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. GASTON MEDICAL ASSOCIATES, PA NPI is 1366433773. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2664 COURT DRIVE
SUITE A
GASTONIA, NC
ZIP 28054-449
Phone: (704) 861-9030
Fax: (704) 833-1234

The provider's authorized official is Olufolarin Akanfe Ajao .
The authorized official title is Co-president and has the following contact phone number (704) 861-9030.

The CLIA number assigned to this NPI record is 34D0974742 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/3/2005 and was last updated on 7/31/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RG0100XInternal MedicineGastroenterology9600912NORTH CAROLINANo
2363L00000XNurse Practitioner201734NORTH CAROLINANo
3363A00000XPhysician Assistant0010-01441NORTH CAROLINANo
4207R00000XInternal Medicine9501167NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12344504MEDICARE ID-TYPE UNSPECIFIEDNORTH CAROLINA
289011FHMEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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