Organization
MARIETTA MEDICAL CLINIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IFEANYI O OKAFOR MD (PRESIDENT)
(704) 866-8030
Entity
Organization
Contact information
Practice address
401 S MARIETTA ST, GASTONIA, NC 28052-4331
(704) 866-8030
Mailing address
PO BOX 550457, GASTONIA, NC 28055-0457
(704) 866-8030
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
200200150
NC
Other
Enumeration date
12/02/2008
Last updated
03/12/2009
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