Individual
DR. GUSTAVO A COLMENARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10545 BLAIR RD, SUITE 1200, MINT HILL, NC 28227-2800
(704) 863-9600
(704) 863-9601
Mailing address
PO BOX 602478, CHARLOTTE, NC 28260-2478
(704) 863-9600
(704) 863-9601
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
DR.0056015
CO
207Q00000X
Family Medicine Physician
2008-01450
NC
207Q00000X
Family Medicine Physician
31295
SC
207Q00000X
Family Medicine Physician
DR.0056015
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
312959
—
SC
05
—
5910201
—
NC
Enumeration date
11/30/2005
Last updated
02/07/2023
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