Individual
GIN WEN LOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3614 S PROVIDENCE RD STE 200, WAXHAW, NC 28173-6310
(704) 384-8640
(704) 384-8650
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2014-00453
NC
Other
Enumeration date
09/02/2010
Last updated
12/02/2024
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