Organization
UNION MEDICAL CLINIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONATUS OGU MD (OWNER)
(704) 866-4607
Entity
Organization
Contact information
Practice address
1574 UNION RD, SUITE A, GASTONIA, NC 28054-5633
(704) 866-4607
(704) 866-5292
Mailing address
1574 UNION RD, SUITE A, GASTONIA, NC 28054-5633
(704) 866-4607
(704) 866-5292
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9300555
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02334
BLUE CROSS BLUE SHIELD
NC
05
—
8910826
—
NC
Enumeration date
06/23/2008
Last updated
09/25/2008
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