Organization
CAROMONT MEDICAL GROUP, INC.
Active
Parent organization
CAROMONT MEDICAL GROUP INC
Other names
Carolinas Plastic Surgery Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
CAROMONT MEDICAL GROUP INC
Authorized official
DAVID MICHAEL OCONNOR (CFO)
(704) 834-2049
Entity
Organization
Contact information
Practice address
2391 COURT DR, SUITE 120B, GASTONIA, NC 28054-2196
(704) 874-0095
(704) 866-8680
Mailing address
PO BOX 744786, ATLANTA, GA 30374-4786
(704) 834-2450
(704) 671-5331
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
024W3
BCBS
NC
05
—
1720377625
—
NC
Enumeration date
03/31/2011
Last updated
08/09/2022
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