Organization
COVENANT PEDIATRICS PA
Active
Other names
SHILOH MEDICALS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONIA OGECHI EMEZIE M.D. (PRESIDENT)
(704) 321-5700
Entity
Organization
Contact information
Practice address
101 E MATTHEWS ST, SUITE 800, MATTHEWS, NC 28105-4866
(704) 321-5700
(704) 321-5701
Mailing address
101 E MATTHEWS ST, SUITE 800, MATTHEWS, NC 28105-4866
(704) 321-5700
(704) 321-5701
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
200301456
NC
261QP2300X
Primary Care Clinic/Center
200301456
NC
Other
Enumeration date
01/14/2014
Last updated
01/26/2015
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