Organization
MOORESVILLE SURGICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID L GISH MD (VP)
(704) 663-7905
Entity
Organization
Contact information
Practice address
123 PROFESSIONAL PARK DR, SUITE 200, MOORESVILLE, NC 28117
(704) 663-7905
(704) 663-5224
Mailing address
123 PROFESSIONAL PARK DR, SUITE 200, MOORESVILLE, NC 28117
(704) 663-7905
(704) 663-5224
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02347
BC
—
05
—
6902347
—
NC
Enumeration date
06/12/2006
Last updated
08/22/2020
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