Organization
GASTONIA MEDICAL SPECIALTY CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANUP BANERJEE M.D. (CORP OFFICER)
(704) 867-2341
Entity
Organization
Contact information
Practice address
1021 X RAY DR, GASTONIA, NC 28054-7489
(704) 867-2341
(704) 867-9019
Mailing address
1021 X RAY DR, GASTONIA, NC 28054-7489
(704) 867-2341
(704) 867-9019
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01627
BCBSNC
NC
Enumeration date
01/05/2011
Last updated
01/05/2011
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