# CAROMONT MEDICAL GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Carolina Cardiovascular and Thoracic Surgery Associates
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649404294
- **Authorized official:** WAYNE F. SHOVELIN (PRESIDENT, CEO)
- **Authorized official phone:** (704) 834-2133

## Contact information

- **Practice address:** 2555 COURT DR, SUITE 270, GASTONIA, NC 28054-2134
- **Practice address phone:** (704) 671-7670
- **Practice address fax:** (704) 671-7672
- **Mailing address:** 2555 COURT DR, SUITE 270, GASTONIA, NC 28054-2134
- **Mailing address phone:** (704) 671-7670
- **Mailing address fax:** (704) 671-7672

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NULL | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/12/2009
- **Last updated:** 05/12/2009