Individual
MR. JEREMY ALAN GAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1915 RANDOLPH RD, CHARLOTTE, NC 28207-1101
(704) 323-2000
Mailing address
4601 PARK RD, STE 300, CHARLOTTE, NC 28209-3239
(704) 323-2000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
101489
NC
Other
Enumeration date
11/23/2005
Last updated
04/19/2023
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