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Individual

DR. WENDELL AUBREY GOINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9336 BLAKENEY CENTRE DR, STE 100B, CHARLOTTE, NC 28277-6666
(704) 759-1770
(704) 759-1760
Mailing address
9336 BLAKENEY CENTRE DR, STE 100B, CHARLOTTE, NC 28277-6666
(704) 759-1770
(704) 759-1760

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
17278
SC
208600000X
Surgery Physician
Primary
94-01199
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
020050993
RAILROAD MEDICARE
SC
01
1395J
BLUE CROSS BLUE SHIELD
NC
05
172789
SC
Enumeration date
12/29/2006
Last updated
02/03/2014
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