# NORTH STATE MEDICAL GROUP, P.A.

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

## Provider details

- **NPI number:** 1922037019
- **Authorized official:** GERALD AHIGIAN M.D. (PRESIDENT)
- **Authorized official phone:** (704) 483-2200

## Contact information

- **Practice address:** 2266 NC 16 BUSINESS NORTH, DENVER, NC 28037-8254
- **Practice address phone:** (704) 483-2200
- **Practice address fax:** (704) 483-2214
- **Mailing address:** 2266 N HIGHWAY 16, DENVER, NC 28037-8254
- **Mailing address phone:** (704) 483-2200
- **Mailing address fax:** (704) 483-2214

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/01/2006
- **Last updated:** 02/18/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 890131U | — | NC |