Individual
DR. GARY LIONELL MANGUM SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1511 N LAFAYETTE ST, SHELBY, NC 28150-2881
(704) 482-5875
Mailing address
1511 N LAFAYETTE ST, SHELBY, NC 28150-2881
(704) 482-5875
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
15526
NC
Other
Enumeration date
11/13/2009
Last updated
11/13/2009
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