Organization
CONCORD WOMEN'S SPECIALTY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JODI RAYMER MARANGONE (PRACTICE ADMINISTRATOR)
(704) 792-1000
Entity
Organization
Contact information
Practice address
200 MEDICAL PARK DR, SUITE 430, CONCORD, NC 28025-2982
(704) 792-1000
(704) 792-1004
Mailing address
200 MEDICAL PARK DR, SUITE 430, CONCORD, NC 28025-2982
(704) 792-1000
(704) 792-1004
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0283F
BCBS GROUP #
NC
01
—
2315197
MEDICARE GROUP
NC
05
—
890283F
—
NC
01
—
CA8448
MEDICARE RAILROAD
NC
Enumeration date
04/19/2006
Last updated
01/14/2008
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