Organization
EAGLE MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GBENGA ALUKO MD (MEDICAL DIRECTOR)
(704) 975-6004
Entity
Organization
Contact information
Practice address
1951 OLD STEELE CREEK ROAD, CHARLOTTE, NC 28208-5631
(704) 926-5434
(704) 454-7388
Mailing address
PO BOX 667889, CHARLOTTE, NC 28266-7889
(704) 926-5434
(704) 454-7388
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2005-01333
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14096
BLUECROSS BLUSHIELD
NC
05
—
278746
—
SC
05
—
5902507
—
NC
Enumeration date
09/09/2009
Last updated
12/12/2009
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