Individual
DR. DEIDRA MCCANTS GATLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7845 LITTLE AVE, CHARLOTTE, NC 28226-8198
(704) 375-0100
(704) 335-3592
Mailing address
PO BOX 470408, CHARLOTTE, NC 28247-0408
(704) 375-0100
(704) 335-3592
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
200600998
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5905339
—
NC
Enumeration date
11/21/2005
Last updated
04/24/2018
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