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Organization
ST MARY'S MEDICAL CLINIC,PC.
Active
Organization
ST MARY'S MEDICAL CLINIC,PC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AWAWU E IGBINADOLOR M.D (PRESIDENT)
(704) 219-2147
Entity
Organization
Contact information
Practice address
701 E ROOSEVELT BLVD, BLDG 800A, MONROE, NC 28112
(704) 225-0211
(704) 225-0221
Mailing address
701 E ROOSEVELT BLVD, BLDG 800A, P.O.BOX 528, MONROE, NC 28111-0528
(704) 225-0211
(704) 225-0221
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
200001486832
NC
Other
Enumeration date
09/10/2007
Last updated
09/10/2007
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