MODERN MEDICAL GROUP PLLC NPI 1861051591

NPI Information

NPI: 1861051591
Provider Name: MODERN MEDICAL GROUP PLLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
936 COX RD STE A
GASTONIA, NC
ZIP 28054
Phone: (704) 497-9544
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MODERN MEDICAL GROUP PLLC is a family medicine in Gastonia, NC. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MODERN MEDICAL GROUP PLLC NPI is 1861051591. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

936 COX RD STE A
GASTONIA, NC
ZIP 28054-456
Phone: (704) 497-9544

The provider's authorized official is Ivette Cintron-cubero .
The authorized official title is Owner/president and has the following contact phone number (704) 497-9544.

The enumeration date for this NPI number is 6/6/2019 and was last updated on 6/6/2019.

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	Primary
1	207R00000X	Internal Medicine		No
2	363LP2300X	Nurse Practitioner	Primary Care	No
3	207Q00000X	Family Medicine		Yes

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
1	56545-1730570136	MEDICAID	NORTH 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

NPI Synchronization or Removal

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