Individual
DR. EDWARD R MOGABGAB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1700 ABBEY PL, STE 200, CHARLOTTE, NC 28209-3734
(704) 262-7240
(704) 262-7249
Mailing address
1700 ABBEY PL, STE 200, CHARLOTTE, NC 28209-3734
(704) 262-7240
(704) 262-7249
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9501609
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59904
BLUE CROSS
NC
05
—
8959904
—
NC
Enumeration date
09/16/2006
Last updated
10/03/2018
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