Organization
GASTON DIGESTIVE DISEASE CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL THOMAS DRAKE I M.D. (PRESIDENT)
(704) 867-3585
Entity
Organization
Contact information
Practice address
2550 COURT DR STE 201, GASTONIA, NC 28054-2152
(704) 867-3585
(704) 861-1779
Mailing address
2550 COURT DR STE 201, GASTONIA, NC 28054-2152
(704) 867-3585
(704) 861-1779
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
23513
NC
Other
Enumeration date
04/19/2007
Last updated
04/17/2008
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