Provider Demographics
NPI:1588003032
Name:CATAWBA VALLEY MEDICAL GROUP, INC
Entity Type:Organization
Organization Name:CATAWBA VALLEY MEDICAL GROUP, INC
Other - Org Name:CATAWBA VALLEY VASCULAR SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLAGHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-326-3800
Mailing Address - Street 1:1771 TATE BLVD SE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-4249
Mailing Address - Country:US
Mailing Address - Phone:828-732-5200
Mailing Address - Fax:828-732-5201
Practice Address - Street 1:1771 TATE BLVD SE
Practice Address - Street 2:SUITE 204
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-4249
Practice Address - Country:US
Practice Address - Phone:828-732-5200
Practice Address - Fax:828-732-5201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-18
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty