Individual
DR. MICHAEL RAYMOND TAMBERELLA III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2555 COURT DR, SUITE 200, GASTONIA, NC 28054-2134
(704) 867-2141
(704) 867-2308
Mailing address
2555 COURT DR, SUITE 200, GASTONIA, NC 28054-2134
(704) 867-2141
(704) 867-2308
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
009800404
NC
207RI0011X
Interventional Cardiology Physician
Primary
9800404
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891364U
—
NC
05
—
N0040G
—
SC
Enumeration date
09/30/2005
Last updated
08/12/2014
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