Organization
GERIDOC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALBERT SHEDERICK FORD JR. M.D. (DOCTOR)
(704) 564-9030
Entity
Organization
Contact information
Practice address
4431 MONTIBELLO DR, CHARLOTTE, NC 28226-7420
(704) 564-9030
Mailing address
4431 MONTIBELLO DR, CHARLOTTE, NC 28226-7420
(704) 564-9030
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
930069
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32996
BCBS
NC
05
—
5909094
—
NC
Enumeration date
02/27/2007
Last updated
06/30/2008
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