Organization
GARY D WALDMAN MD PA
Active
Organization
GARY D WALDMAN MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WENDY J FORBIS (ADMINISTRATOR)
(704) 542-8018
Entity
Organization
Contact information
Practice address
10512 PARK RD, SUITE 113, CHARLOTTE, NC 28210-8469
(704) 542-8018
(704) 542-7147
Mailing address
10512 PARK RD, SUITE 113, CHARLOTTE, NC 28210-8469
(704) 542-8018
(704) 542-7147
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0172L
BLUE CROSS BLUE SHIELD
—
01
—
CD7109
RAILROAD MEDICARE
NC
Enumeration date
11/20/2006
Last updated
04/03/2012
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