# ST MARY'S MEDICAL CLINIC,PC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588859953
- **Authorized official:** DR. AWAWU E IGBINADOLOR M.D (PRESIDENT)
- **Authorized official phone:** (704) 219-2147

## Contact information

- **Practice address:** 701 E ROOSEVELT BLVD, BLDG 800A, MONROE, NC 28112
- **Practice address phone:** (704) 225-0211
- **Practice address fax:** (704) 225-0221
- **Mailing address:** 701 E ROOSEVELT BLVD, BLDG 800A, P.O.BOX 528, MONROE, NC 28111-0528
- **Mailing address phone:** (704) 225-0211
- **Mailing address fax:** (704) 225-0221

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2300X | Primary Care Clinic/Center | 200001486832 | NC | Yes |

## Other

- **Enumeration date:** 09/10/2007
- **Last updated:** 09/10/2007